Lec 3: Lumbar stenosis Flashcards
MC form of central stensosis
Aquired central stenosis
Neurological deficits many crosss ____ during central stensosi
dermatomal and other nerve root boundaries
like in stenosis
Stoop test can test positive for ____
Central stenosis
____ test: pt walks briskly for 1 min. When the doc sees that the pt is experiencing pn, they stop them and have them flex forward
(+) sx are alleviated when flexed
stoop test
indication: neurogenic intermittent claudication
\_\_\_\_\_ central stenosis is: intermitted relieved when flexed forward PN: Prox --> distal peripheral pulse is the same
Neurogenic intermitted central stensosis
_____ central stenosis is:
caused by artherosclerosis
pm in gastrocnemius
decr. or absent peripheral pulse
Vascular claudication from central stensosis
cc______: Bony/ soft tiss encroachment –> often at many levels
Central stenosis
cc___: pn/ dysfunction arising from the z-jt. local and referred pn from the z-jt
facet sx
____ is the MC location of facet sx
L5/S1 –> bc the transitional jt is more coronal & COG
During facet sx, pn is (above/ below) the knee
above
cc_____: is a jt asymmetry- a turn in the orientation of the facet
joint tropism
MC location of tropism
L4/L5
L5/S1
Name the grades of sp/st
grade 1: Mild
- mild stretch of the M/ lig w/o tearing
Grade 2 Mild
- tearing is less than 100% of the fiber. Jt laxity
Grade 3: severe
- total torn
at _____ position the L/S M are relaxed –> increase injury
full flexion
cc____: has radicular pn
Pn travels past knee into the foot
lumbar disc
cc___: pn worsens with walking. PN decr when stopping forward. It crosses multiple N roots
Lumbar stenosis
cc_____ : PN upon extension. The PN will rarely travel past the knee
Facet sx
cc____: PN at rest from a hx of trauma
Lumbar sp/st
What are the two MC spondylolisthesis
Type II: Isthmic
Type III: Degenerative
MC location for a degenerative spondylolisthesis
L4
MC location for a isthmic spondylolisthesis
L5
cc____: interrupton or break in the pars interarticularis
spondylolysis
MC population for a Isthmic spondylolisthesis?
Slippage in _____
Athletes
slippage in children under 10
(weaknes in iliolumbar lig and TPs not well developed )
Type III: degenerative spondylolisthesis 3F’s
female
40 yo
L4
Which grades of a spondylolisthesis slippage are stable? Which are unstable
grade 1 &2 = stable
Grade 3 & 4 = unstable
a complete 100% slippage of a spondylolisthesis is called a ____
spondyloptosis
When does surgery for Spondylolisthesis seen to be the most successful?
When there is Spondylolisthesis WITH neuro changes
