Conditions of the spine

Question 1

Cervical sprain- Eti

Answer 1

MVA or other high impact with resistance

Question 2

Cervical sprain- Sx

Answer 2

Occipital HA, blurred/ double vision, dysphagia, jaw pain, vertigo, Pain, decreased ROM on neck.

Question 3

Cervical sprain- Dx

Answer 3

Clinical & x-ray to rule out further trauma

Question 4

Cervical sprain- Tx

Answer 4

Soft immobilization, reassurance to use full ROM, bed rest

Question 5

Acute lumbosacral strain- Eti

Answer 5

Pain following lifting or twisting

Question 6

Acute lumbosacral strain- Sx

Answer 6

Unilateral deep, steady pain in mid to low back. Radiate to butt & thigh, relief with rest, pain with activity

Question 7

Acute lumbosacral strain- Dx

Answer 7

asymmetric lateral bending, local deep tenderness present on exam

Question 8

Acute lumbosacral strain- Tx

Answer 8

NSAIDs, activities as tolerated, muscle relaxants

Question 9

Lumbar disc herniation- Eti

Answer 9

Heavy bending with back in flexion- may be degenerative with no inciting incident. L5-S1 90% cases

Question 10

Lumbar disc herniation- Sx

Answer 10

Pain with flexion or sitting, numbness & weakness, radicular pain with compression.

Question 11

Lumbar disc herniation- Dx

Answer 11

X-ray- change in alignment, narrowing disc space, osteoarthritis

Question 12

Lumbar disc herniation- Tx

Answer 12

NSAIDs, PT, activity modification, steroid injections

Question 13

Spinal stenosis- Eti

Answer 13

50+ Often due to osteoarthritis or large disc herniation

Question 14

Spinal stenosis- Sx

Answer 14

Pain worse with extension, neuralgic claudication with walking, relief with sitting, limited extension of lumbar spine, radiation down legs

Question 15

Spinal stenosis- Dx

Answer 15

Neurovascular & X-ray

Question 16

Spinal stenosis- Tx

Answer 16

PT, steroid injections

Question 17

Spondylolisthesis- Eti

Answer 17

Abnormal slippage of vertebra. L4/5 50+

Question 18

Spondylolisthesis- Sx

Answer 18

Low back and leg pain with radicular leg symptoms

Question 19

Spondylolisthesis- Dx

Answer 19

X-ray

Question 20

Spondylolisthesis- Tx

Answer 20

Decompression or fusion

Question 21

Spondylolysis- Eti

Answer 21

Common in children & adolescents- defect or stress fracture at L5 (95%)

Question 22

Spondylolysis- Sx

Answer 22

insidious back pain, worse with activity, neurologic sx rare. Pain with lumbar extension

Question 23

Spondylolysis- Dx

Answer 23

X-ray or CT

Question 24

Spondylolysis-Tx

Answer 24

Rest, brace, PT

Question 25

Cauda equina Syndrome- Eti

Answer 25

Compression and dysfunction of lumbosacral nerve roots. Surgical emergency

Question 26

Cauda equina Syndrome- Sx

Answer 26

Saddle anesthesia, loss of bowel/ bladder function, lower extremity weakness

Question 27

Cauda equina Syndrome- Dx

Answer 27

Clinical & x-ray

Question 28

Cauda equina Syndrome- Tx

Answer 28

Stabilization of spine & surgery

Question 29

Scoliosis- Eti

Answer 29

spinal deviation on the vertical axis greater than 10 degrees.

Question 30

Scoliosis- Sx

Answer 30

Asymptomatic, may progress to sciatica or low back pain as adult. Uneven ribs, shoulders or pelvis

Question 31

Scoliosis- Dx

Answer 31

Adam test, X-ray

Question 32

Scoliosis- Tx

Answer 32

Serial observation unless complicated.

Question 33

Costochondritis- Eti

Answer 33

Before 40, mono joint involvement. Painful swelling of 1+ costochondral articulation,

Question 34

Costochondritis- Sx

Answer 34

Anterior chest pain- sudden or gradual- radiation to arms, aggravated by coughing

Question 35

Costochondritis- Tx

Answer 35

NSAIDs, steroid injections