Congenital Anomalities Flashcards
injections of Dextrose (a regenerative irritant into the ligaments or joints
that Stimulates the Release growth factors and collagen deposits
Increases ligament and tendon size
Repairs articular cartilage defects
vertebral block treatment
how do you treat hemivertebrae
Surgical excision early in childhood
In an adult with a hemivertebra in the lower lumbar spine
OMT –
Used to keep spine mobile prior to surgery creating better outcome
To help body adapt to heel lift
anomaly most found in lumbar spine, T11, T12, T1 and may be associated with kyphoscoliosis
butterfly vertebra
Buttock dimpling, “Sitting Buddah”,
Extended knees, flexed hips and equinovarus feet
Treatment: Operative, Spinal stabilization for progressive kyphosis & scoliosis
Limb amputation
Sacral Agenesis
since L1-2 facets are more sagittal ot limits
rotation
since L4-5 facets are more coronal it limits
flexion
Disc herniation signs and symptoms
Antalgic gait, lean toward the side of the disc herniation, pain sciatic sharp shooting pain radiation from buttock to posterior thigh to calf and into the foot
Pain with prolong sitting increases
Straight leg raising test positive with pain to the back
Weakness in big toe dorsiflexion with numbness
whats different between iliolumbar ligament and facet pain
Iliolumbar ligament pain = low back, hip and groin area
Facet pain = local pain/pressure at affected joint and the hip, buttock & back of thigh with extension,
’ fracture in the pars interarticularis of the vertebral arch
spondylolysis
Incomplete closure of the pars (L5-S1)
Posterior facet joints
Elongation of the pars interarticularis
Pars remains intact
congenital spondylolisthesis
Clinical Presentation in Young people < 30 years: dysplastic spondylolisthesis
Brought in for evaluation for change in gait or posture, Gait = stiff legged, short stride, waddling, Tight hamstrings working to stabilize the L5-S1 junction
isthmic spondylolisthesis
most common type. Caused by repetitive stress fractures to the pars interarticularis, especially due to hyperextension. Pars stress fracture occurs around 5-7 years of age, t common at L5-S1 (Cumulative stress)
Spondylisthesis type A,B,C
Dysplastic Type:
Pars defect at L5—S1 has horizontal facet allowing entire vertebra with posterior elements to slip forward
Creating drop off sign between L5-S1
Isthmic Type:
Pars defect at L5-S1 allows anterior vertebral body to slip forward leaving the posterior elements. Drop off felt at L4-L5
Degenerative:
L4-L5 has no pars defect but degenerative facets and disc
Drop off sign felt between L4-L5
Sacralization
One or both of the L5 transverse processes either:
Articulates with a pseudoarthrosis (Batwing Transverse Process)
Fuses with the sacrum (Partial at L5)
Lumbarization
Lumbarization: Failure of S1 to fuse with the rest of the Sacrum (less common)
