Lower back pain and intervertebral disc herniation

Question 1

Lower back pain

involves and causes:

Answer 1

- involves:

muscles, nerves and bones of the back

- causes:

muscle strain, inflammation, tumours, disc herniation, spinal stenosis, compression fracture

Question 2

Intervertebral disc herniation

define complications:

Answer 2

• tear/weakness in outer annulus fibrosis –> nucleus pulposus bulges out –> compresses nearby nerve
• can occur in cervical (most often C5,6,7), thoracic or lumbar (L4, L5, sacrum) region

Question 3

Intervertebral disc herniation

Types:

Answer 3

types:

- bulge – no outpouching

• - protrusion* – contained, sub-ligamentous herniation
• - extrusion* – non-contained, transligamentous

herniation

- sequestration – free fragment

Question 4

Low back pain and intervertebral disc herniation

Causes:

Answer 4

causes**:

age-related degeneration, wear and tear (jobs requiring constant sitting, squatting, driving)

Question 5

Low back pain and intervertebral disc herniation

Symptoms :

Answer 5

symptoms:

neck pain, lower back pain, numbness, tingling, paraesthesia, muscular weakness, paralysis

Question 6

sciatica

define:

Answer 6

sciatica:

• leg pain, tingling, numbness, weakness
• originates in lower back then travels through buttock and down back of leg (route of sciatic nerve)
• due to impingement of sciatic nerve roots by herniated disc

Question 7

cauda equine syndrome:

define:

Symptoms-Tx:

Answer 7

• rare
• due to prolapsed disc pressing the nerves at the very bottom of the spinal cord

- symptoms: low back pain, bowel dysfunction, bladder dysfunction, saddle numbness, leg weakness

• urgent Tx required to preserve the nerves to bowel and bladder

Question 8

Cauda equina

define

Answer 8

_{(from Latin <u><em>horse's tail</em></u>) is a <em><u>bundle of spinal nerves</u></em> and <em><u>spinal nerve rootlets</u></em>, The cauda equina <em><u>occupies the lumbar cistern</u></em>, a <em><u>subarachnoid space inferior to the conus medullaris</u></em>.}

_{The <u><em>nerves</em></u> that <em><u>compose the cauda equina innervate the pelvic organs </u>and <u>lower limbs</u> to include motor innervation of the hips, knees, ankles, feet, internal anal sphincter and external anal sphincter. In addition, the cauda equina extends to sensory innervation of the perineum and, partially, parasympathetic innervation of the bladder</em>}

Question 9

Cauda equina syndrome

Causes: describe all required

Answer 9

_{syndrome is a particularly serious type of nerve root problem that can be <u><em>caused by a prolapsed disc.</em></u>}

_{This is a rare disorder where the nerves at the very bottom of the spinal cord are pressed on.}

_{This syndrome can cause low back pain plus: Problems with bowel and bladder function (usually inability to pass urine).}

_{Numbness in the saddle area around the back}

_{passage (anus).}

_{Weakness in one or both legs. Urgent treatment requird to preserve the nerves to the bladder and bowel from becoming permanently damaged.}