Low Back DDx Flashcards
What tests are most conclusive for Disc Herniation?
Well Leg Raise
Turyn’s
Naffzigger’s
What increases pain with a disc herniation?
upon waking up, sitting, and flexion
What is the ‘key’ to differentiating between a disc protrusion and a disc extrusion?
the PLL
What is it called when the PLL is still intact with a HNP (also known as contained herniation)?
Disc protrusion
What is it called when the PLL ruptures due to a HNP (also known as transligamentous herniation)?
Disc extrusion
What is it called when a ‘chunk’ or ‘fragment’ of nuclear material has detached itself from the main body of the extrusion and is loose in the epidural space which may cause cauda equina syndrome? (heavy leg pain, minimal back pain)
Disc sequestration
What kind of herniation has “direct” antalgia (Torso lean is toward the side of leg pain)?
Medial herniation
What kind of herniation has “indirect” or crossed antalgia (Torso lean is away from the side of leg pain)?
Lateral herniation
What kind of herniation has no antalgia (Torso lean is directly forward without side preference)?
Sub-Rhizal
T/F: L3 disc = disc between L3 and L4
True
T/F: L3 disc hits the L4 root
True
To whom do disc herniations typically effect?
30-50 year olds when the disc is still viable (avg. 42 year olds)
What is the first step towards disc herniation?
Disc Bulge
What type of herniation is easier to treat?
Lateral herniation
What motor/reflex/dermatome test is used to test L3 disc/L4 nerve root?
Motor: Tibialis anterior (inversion)
Reflex: Patellar reflex
Dermatome: tibial bone
