L Spine Pathologies Flashcards
which l spine pathologies are the same as c/t spine
wedge #
burst #
chance #
scoliosis
what is lordosis?
caused by?
symptoms?
when is treatment needs and what is it?
exaggerated curvature of l spine
poor posture/obesity/OP/discitis/kyphosis/spondylolithesis/ achondroplasia (dwarfism where cartilage doesn’t ossify)
pain/muscle spasms/tingling/numbness/bladder or bowel difficulties
if curve doesn’t reduce on flexing forward then treatment needed as its considered rigid
treatment depends on severity from analgeisa/physio to bracing/surgery
what is Spondylosis
what are the 4 typical appearances?
what occurs due to growth of osteophytes?
what is the treatment?
loss of joint space due to decreased disc height, causing the facets to move differently becoming overly mobile and leading to growth of bony spurs (osteophytes)
1 - osteophytic lipping
2 - sub-chondral sclerosis
3 - reduced disc space height
4 - reduced joint space
as the osteophytes progress the ‘out growths’ from the vertebrae above and below fuse together (osteophytic lipping) accompanied by sub-chondral sclerosis - areas of increased density at the periphery of the vertebral bodies
medical and physical therapy to ease symptoms - no cure because its a degenerative condition
what is the predisposition for spondylosis?
what can cause this predisposition?
what treatment is given to deal with these symptoms?
OA of spinal joints and foramina causing pressure on nerve roots affecting motor and sensory stimulus causing pain paresthesia and muscle weakness
ageing compromises structure of intervertebral discs - weakens structure of annulus fibrosis causing wear and tear, water content of nucleus decreases with age reducing shock absorbance and decreasing disc height
analgelsia/anti-inflammatories/physio all help maintain symptoms, pain-killing injections may also be administered
severe cases = surgery to remove osteophytes/portions of disc and laminectomy to relieve pressure on nerve roots
what is Ankylosing Spondylitis?
what is the onset?
what is the cause?
what else can it be known as?
is there any treatment?
chronic inflammatory disease of joints of spine and SIJs
most likely between 15-25 years
linked to genetics and can lead to complete rigidity of spine
‘Bamboo spine’ as outer fibres of fibrous intervertebral disc ossify between vertebrae
no treatment to cure - meds to manage symptoms - analgesia/anti-inflammatories/disease modifying meds (e.g. sulfsalazine)
surgery can involve joint replacement and corrective surgery but only used in low risk severe cases
what is Spondylolisis?
what are the causes? - 4 points
what is the treatment?
fault across the pars interarticularis - precedes spondylolisthesis
congenital / degenerative / traumatic / pathologic
surgery to correct fault and prevent spondylolisthesis, followed by physio / some immobilisation / analgesia / anti-inflammatories
what is Spondylolisthesis?
how is it caused? - 4 points
what is the treatment?
how may a pt present and what must be done in this case?
slippage of L5 vertebrae over S1 (can be everywhere but this is most prevalent)
congenital / degenerative / traumatic / pathologic
surgery to stabilise spinal component and reduce spinal compression - intervertebral fusion/surgical rods/2 plates used to stabilise # sites
haemodynamically unstable because of nature of injury - this needs to be treated before any injury - pt will be hospitalised during recovery, can take up to 2 years for full recovery
what is Spondyloptosis?
what are the symptoms? - 3 points
what is the treatment?
complete separation of the vertebrae - profession from spondylolisthesis
hyper-lordosis, restricted movement, pain
variety of surgical approaches using internal fixation devices, bracing and physio to make a good recovery
what are the causes of a prolapsed intervertebral disc? - 3 points
tear in outer annulus fibrosis of disc causing nucleus pulpopus to bulge out from central portion to outer ring (evident when disc under pressure) - related to AGE where annulus fibrosis = thinner allowing potential for nucleus pulpopus to escape
lifting injury - disc = under pressure and herniates
genetic link - make up of annulus fibrosis affected causing it to become brittle sooner allowing escape of nucleus
does the disc move completely? why/why not?
doesn’t move completely because its so well attached to spinal vertebrae - herniates
what are the symptoms of a prolapsed intervertebral disc? - 2 points
varying degrees of pain in relation to which nerve is impeded, more serious cases = long standing damage to nerve causing bowel/bladder/sexual dysfunction
how is a prolapsed intervertebral disc diagnosed?
which modality is best/unnecessary?
physical exam (e.g. raise test) MRI = desirable choice due to capabilities in showing soft tissue - not applicable for primary imaging
what is the treatment for a prolapsed intervertebral disc?
NSAIDs, possible epidural injections, physio - 12 weeks for recovery
surgery can be used in more severe cases
what is a spina bifida occulta?
at what point does this occur?
what are the radiographic appearances/symptoms?
incomplete closure of vertebral canal whereby some vertebrae remains unfused causing part of the spinal canal to be exposed (occulta = hidden)
at embryonic stage of development
mildest form - spinal cord doesn’t protrude and there’s no neural deficit - possibly no evidence at skin surface other than possible dimple/hair growth - often an incidental finding/asymptomatic
what are the causes for loss of spinal curvature? - 3 points
what is the treatment?
neglecting to maintain good posture, OP, obesity
traction therapy and physio to assist with regaining proper posture
sometimes spinal fusion is needed to address abnormal curvature by fusing the vertebrae so they can’t drift out of place - spine loses some of its flexibility and elasticity
