Clinical Considerations

Question 1

Clinical Considerations 1

Answer 1

-Herniated disc
-Lumbar puncture
-Epidural anesthesia
-Vertebral fractures
“Hangman” Fracture
Jefferson Fracture
Fractures of the axis (C2) usually involve the dens (type I, II, III)

Question 2

Clinical Considerations 2

Answer 2

Kyphosis
• Round shoulder deformity “humpback”. Exaggeration of the thoracic curvature in the sagittal plane

Lordosis
• Exaggeration of the lumbar curvature in the sagittal plane; “sway back”

Scoliosis
• Exaggeration of the curvatures in the coronal plane
• May be functional, e.g. limb-length discrepancy

Question 3

Clinical considerations 3

Answer 3

Disease and Intervertebral Foramina:
-These foramina transmit the spinal nerves and the small segmental arteries and veins. Each foramen is bounded anteriorly by the vertebral body and intervertebral disc,
posteriorly by the by the articular processes and the joints between then, superiorly and inferiorly by the pedicles.

Spondylolysis:
Developmental defect in the pars
interarticularis (pedicle) of the lumbar vertebrae resulting in (Spondylolisthesis) forward displacement of a lower lumbar vertebra, usually L5, and the vertebra
below (S1). The essential defect is in the pedicles of the migrating vertebra.

The scotty dog sign refers to the normal
appearance of the lumbar spine when seen
obliquely. On oblique views, the posterior
elements form the figure of a Scotty dog
with:
• the transverse process being the nose • the pedicle forming the eye • the inferior articular facet being the front leg • the superior articular facet representing the ear • the pars interarticularis (the portion of the
lamina that lies between the facets) equivalent
to the neck of the dog.

Question 4

Clinical Considerations 4

Answer 4

• Spinal Stenosis: narrowing of the spinal canal occurs as the patient ages (generally about the fourth decade). Osteoarthritis with osteophyte formation, and degenerative changes in the intervertebral discs can lead to narrowing of the spinal canal and intervertebral foramina. Symptoms may vary from mild to severe (pain, inability to walk…).
• With aging, the vertebral column decreases in length due to degeneration of the intervertebral discs. Reduction in mobility and flexibility also occurs.