Discs Flashcards
Internal disc derangement can progress into…
a herniation
Annulus failure is often a combination of…
flexion, rotation, and compression
How much trauma is required for herniation?
Less trauma/loading than you might think if there has been repetitive microtrauma over time
What are four disc herniation terms in order of least to most severity?
- Degradation/Derangement
- Disc Protrusion
- Disc Extrusion
- Disc Sequestration
Describe the nucleus and annulus in a contained disc lesion
Which herniation terms apply?
No expression of nuclear material, annular fibers are still intact
Degredation/Derangement and Protrusion
Describe the nucleus and annulus in an uncontained disc lesion
Which herniation terms apply?
Nucleus has breached the annulus and is exposed
Extrusion and Sequestration
When using disc terminology, how is the margin of the disc bulge described?
Symmetrical or asymmetrical
How does disc protrusion appear from the top of the disc?
Protrusion will have a base wider than its peak
How does disc extrusion appear from the top of the disc?
Extrusion will have a narrow base to the bulge
How does protrusion appear in relation to vertebrae?
Base is wider than peak and stays confined to vertebral dimension of disc space
How does extrusion appear in relation to vertebrae?
Narrow base and can extend beyond endplates
What is nuclear sequestration?
Loss of continuity with “parent disc”
Describe mild, moderate, vs severe herniation
Mild: <1/3 of vertebral canal
Moderate: 1/3-2/3
Severe: >2/3
Describe leg symptoms presented with a non-contained disc
May present with radicular pain into the leg that can travel below the knee depending on which nerve is involved
In a lumbar disc herniation, the ___ nerve root will most likely be affected
transiting
For an L4-L5 disc herniation, which nerve root will be affected?
L5
What is canal stenosis?
Narrowing of the spinal canal due to ligamentous hypertrophy, degenerative changes, osteophytes, herniation
Canal stenosis is more frequently seen in which individuals?
Older individuals (especially over 50)
What can canal stenosis present with?
Leg pain, numbness, tingling, weakness
What motion relieves symptoms of canal stenosis?
Forward flexion
What motions are provocative to canal stenosis symptoms?
Stairs depending on direction (up is better)
Lying in bed
What is claudication?
Pain in an extremity
May also be described as fatigue, heaviness, weakness in the leg
What is claudication typically relieved by?
Rest or positional changes
What are the types of claudication?
What test helps differentiate between them?
Vascular or neurogenic
Bicycle test differentiates
List five symptoms of cauda equina syndrome
- Leg pain (may be bilateral)
- Saddle anesthesia/paresthesia
- Loss of bowel or bladder control
- Sexual dysfunction
- Gait disturbances
