Lecture 1: Assessment of Thoracolumbar Spine

Question 1

What type of curve do you see in thoracic spine?

Answer 1

Convex Curve

Question 2

What type of curve do you see in lumbar spine?

Answer 2

Concave Curve

Question 3

Why would you percuss the spine?

Answer 3

• Identify tender/painful points
• Identify fractures or bony injuries

Question 4

Why would you auscultate the spine?

Answer 4

Can find respiratory or renal issues

Question 5

What are the most common reasons for lower back pain?

Answer 5

• Compression Fracture
• Osteomyeleitis
• Muscle spasm
• Muscle strain/sprain

Question 6

What is the ideal age to start scoliosis screening?

Answer 6

Age 10

Question 7

What is the danger of early onset scoliosis?

Answer 7

• Can lead to malformed ribs
• Affect lung development
• Can continue to worsen into adulthood

Question 8

What is the most common form of scoliosis?

What age group does it affect?

Answer 8

Adolescent Idiopathic Scoliosis

• Ages 10-18
• 4/100 children can be affected*

Question 9

Scoliosis is defined as a curvature of the spine in what plane?

How many degrees of curvature defines scoliosis?

Answer 9

Coronal Plane

10^o

Question 10

How many people with scoliosis need treatment?

Answer 10

10% of the affected scoliosis patients

Question 11

Between males and females, which sex has a higher risk of curve progression?

Answer 11

Females

Question 12

How can adults develop scoliosis?

Answer 12

Progression of congenital scoliosis or secondary to other conditions (paralysis, taruma, spinal surgery)

Question 13

How would you screen for scoliosis?

Answer 13

• Differences in height of shoulders or scapulae
• Asymmetry of waistline
• Asymmetry in distance that the arms hang from trunk
• Head shifted to one side and not centered over sacrum
  
  • Called Trunk Shift
• Plumb line dropped from spinous process of 7th cervical vertebra

Question 14

What is spondylitis?

Answer 14

Inflammation of spinal joints

Question 15

What is spondylosis?

Answer 15

Degeneration of intervertebral disks that can result in a painful condition of the spine

Question 16

What is spondylolysis?

Answer 16

Defect or stress fracture in pars interarticularis of vertebral arch

Question 17

What is spondylolisthesis?

Answer 17

Vertebral body slipped forward over another

Question 18

When would you perform surgery to treat scoliosis?

Answer 18

When the angle is >39-50^o

Question 19

What are some symptoms of Cauda Equina Syndrome?

Answer 19

• Progressive motor or sensory deficit
• Saddle Anesthesia
• Bilateral Sciatica or Leg Weakness
• Difficulty urinatin
• Fecal Incontence
• Additional indicators of nerve root problems

Question 20

What are indicators of spinal pathology?

Answer 20

• Onset at <20 years or >50 years
• Pain unrelenting at night or unrelated to time or activity
• Widespread neurological symptoms
• Unexplained weight loss
• Fever/chills
• Trauma
• Spinal deformity

Question 21

What are symptoms of sciatica?

Answer 21

• Low back pain that can radiate down to LE
• History of numbness or weakness
• Burning or tingling in legs
• A shooting pain that makes it difficult to stand up

Question 22

What are symptoms of spinal stenosis?

Answer 22

• Painful cramps
• Numbness, tingling, or weakness in a foot or leg
• Pain or cramping in one or both legs when you stand for long periods of time or when you walk, which usually eases when you bend forward or sit
• Back pain

Question 23

What is ankylosing spondylitis?

Answer 23

• Form of arthritis that primarily affects the spine
• Causes inflammation of the spinal joints (vertebrae) that can lead to severe, chronic pain and discomfort

Question 24

What are symptoms of ankylosing spondylitis?

Answer 24

• Age at onset <40
• Morning back stiffness
• Pain and stiffness in your lower back and hips