Lumbar Spine Flashcards
Mechanical back pain
What is it?
What are the risk factors ?
- pain when spine is loaded, worsens when exercise and relieved by rest
- obesity, poor posture, sedentary lifestyle, incorrect manual handling
Disc degeneration
What is it?
What is marginal osteophytosis?
How does radicular pain arise?
- NP dehydrates wih age > decrease in height > bulging of disc > alteration of load on joints
- syndesmophytes develop adjacent to end plates of disc
- disc height decreases + arthritis in facet joints > intervertebral foramina decrease in size > spinal nerve compressed
Slipped disc
Name the 4 stages of disc herniation and describe them
- Disc degeneration : disc ageing > dec in height and bulging
- Prolapse : NP still contained within rim of AF
- Extrusion : NP braks through AF, still contained within disc space
- Sequestration : NP enters spinal canal
Slipped disc
What is the most common sites for slipped disc?
What nerves do paracentral and far lateral prolapses affect?
- L4/5 & L5/S1
- Paracentral - Traversing nerve root
Far lateral - Exiting nerve root
Sciatica
What is it ?
What are the nerve roots for Sciatic nerve?
What causes Sciatica?
What is the rule of thumb for affected area?
- pain caused by compression of one or more nerve roots contributing to the sciatic nerve
- L4-S3
- marginal osteophytosis, slipped disc
- from back to dermatome
Cauda Equina Syndrome
What causes it?
What are the red flag symptoms?
What is the treatment?
What is the complication?
- disc prolapse, tumours, meninges, spinal stenosis, vertebral fractures
- bilateral sciatica, saddle anesthesia, painless urinary retention, urinary & faecal incontinece, erectile dysfunction
- surgical decompression within 48 hrs of onset sphincter symptoms
- impotence, self-catherisation, manual rectal evacuation, lower limb weakness
Spinal canal stenosis
What is it?
What causes it ?
What are the symptoms?
- abnormal narrowing of spinal canal that compress spinal cord or nerve roots
- disc bulging, facet joint ostheoarthritis, ligamentum flavum hypertrophy
- numbness & weakness below level of stenosis, neurogenic claudication, bilateral symptoms
Neurogenic claudication
What is it?
What causes it?
- Pain of pins and needles in the legs when walking, radiating in a sciatic distribution
- compression of spinal nerve at lumbarsacral region
Spondylolisthesis
What is it?
What are the symptoms?
- anterior displacement of vertebrae above on the vertebrae below
- asymptomatic, lower back pain, sciatica, neurogenic claudication
