Lumbar Spine Flashcards
what can you see in a R & L posterior oblique projection
articulating processes
zygapophyseal joints
pars interarticularis
scotty dog
left posterior oblique has what z-joint facing
left downside
right anterior oblique has what z-joint facing
left upside
what is good to see for a coned lateral view L5-S1
3 parallel lines of vertebral bodies
disc spaces
lumbosacral angles
what are the lumbosacral angles seen in a coned lateral view L5-S1
barges
fergusons
AP axial of SIJs what can u see
articular surfaces superimposed
smooth osseous margins
symmetry SIJs
L5/S1
coccyx
basic protocol for CT
lower thoracic to SIJ or less
axial slices - reformatting to sagittal & coronal
what has high prevalence rates in asymptomatic populations
disc protrusion
what is reported in asymptomatic or symptomatic populations and considered an incidental finding
spondylolysis
what is indicated by a 3-4mm anterior slippage advocated as a threshold of instability
spondylolysthesis
suspected spine trauma
age > or = to 16
blunt trauma meeting criteria for thoracic and lumbar
initial image
CT
suspected spine trauma
age > or = to 16
acute thoracic or lumbar spine injury detected on x-ray or noncontrast CT
neurologic abnormalities
next image
MRI
suspected spine trauma - child
younger than 16, suspected thoracolumbar spine trauma
initial image
x-ray
LBP
acute LBP w/ or w/o radiculopathy
no red flags
no prior management
inital image
none
LBP
subacute or chronic LBP w/ or w/o radiculopathy
no red flags
no prior management
initial image
none
LBP
subacute or chronic LBP w/ or w/o radiculopathy
surgery or intervention candidate w/ persistent or progressive symptoms during or following 6wk of optimal medical management
inital image
MRI
LBP
LBP w/ suspected cauda equina syndrome
initial image
MRI
LBP
LBP w/ hx of prior lumbar surgery w/ or w/o radiculopathy
new or progressing symptoms or clinical findings
initial image
x-ray
MRI
CT
LBP
LBP w/ or w/o radiculopathy
one or more of the following: low-velocity trauma, osteoporosis, elderly individual, chronic steroid use
inital image
x-ray
MRI
CT
LBP
LBP w/ or w/o radiculopathy
one or more of the following: suspicion of cancer, infxn, immunosuppression
initial image
MRI
back pain - child
w/ none of the following clinical red flags: constant pain, night pain, radicular pain, pain lasting >4wk, abnormal neurologic examination
initial image
none
back pain - child
w/ 1 or more of the following: constant pain, night pain, radicular pain, pain lasting >4wk, abnormal neurologic examination
initial image
x-ray
