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Musculoskeletal > lumbar spine pathologies > Flashcards

lumbar spine pathologies Flashcards

1
Q

What population is isthmic type spondylolisthesis commonly seen in?

A

Younger population (9-18 y/o)

often athletes with repetitive lumbar EXT combined with ROT

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2
Q

A ___ fracture leads to anterior slippage of the vertebrae

A

pars

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3
Q

What are the subjective findings of isthmic type spondylolisthesis?

A
  • acute LBP
  • bilateral radicular pain
  • radiculopathy
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4
Q

What are the objective findings of isthmic type spondylolisthesis?

A
  • restricted/painful lumbar EXT
  • (+) bilateral SLR for neural tension
  • (+) neuro signs
  • lumbar PA pain
  • step off of spinous process during palpation
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5
Q

What radiograph MRI view confirms a bilateral pars interarticularis fracture?

A

oblique view MRI

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6
Q

What type of spondylolisthesis is known as the “scotty dog” sign?

A

isthmic type

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7
Q

What population is degenerative type spondylolisthesis commonly seen in?

A

older population, females

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8
Q

What is the most common level for isthmic type spondylolisthesis?

A

L5/S1

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9
Q

What is the most common level for degenerative type spondylolisthesis?

A

L4/L5… followed by L3/L4

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10
Q

What are the subjective findings for degenerative type spondylolisthesis?

A
  • GRADUAL LBP
  • bilateral buttock pain
  • bilateral radicular pain
  • radiculopathy
  • pain agg w/ standing and walking
  • pain relief with sitting
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11
Q

What are the objective findings for degenerative type spondylolisthesis?

A
  • restricted/painful lumbar EXT
  • (+/-) SLR for bilateral neural tension
  • (+) neuro signs
  • Lumbar PA pain
  • step off of spinous processes while palpating
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12
Q

definition: pars fracture but with no anterior slippage

A

spondylolysis

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13
Q

definition: pars fracture with anterior slippage

A

spondylolisthesis

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14
Q

> ___% of spondylolisthesis cases can be treated conservatively

A

90%

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15
Q

What are indications for surgical fusion surgery when treating spondylolisthesis?

A
  • significant neuro symptoms (drop foot, progressive s/s, etc)
  • unrelenting symptoms
  • bowel/bladder symptoms
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16
Q

What are the most common tumors in the spine?

A

spinal metastases

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17
Q

What are the most common primary sites that metastasize to the spine?

A
  1. breast
  2. lung
  3. prostate
  4. renal
  5. GI
  6. thyroid
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18
Q

(true/false) multiple myeloma can often manifest in lower thoracic/upper lumbar spine.

A

true

19
Q

(true/false) vertebral crush fractures can occur due to bone degradation

A

true

20
Q

LBP in what region should cause suspicion for spinal cancer?

A

L1/L2

21
Q

What is the highest predictor of spinal cancer?

A

PMH of Cancer

22
Q

What diagnostic imaging is the gold standard for identifying spinal tumors?

A

MRI

23
Q

definition: anterior vertebral body loses height due to degenerative conditions such as osteoporosis and can fracture under stress

MVAs/bone cancer

A

compression fractures

24
Q

What are the most common regions for compression fractures?

A

T11-L2

25
Q

definition: anterior and posterior aspects of the vertebral body are fractured.

MOI: landing on feet after falling from a significant height…. MVA

A

axial burst fracture

26
Q

definition: less common fracture mostly caused by rotational or lateral flexion injuries

  • can hace avulsions Fx of psoas muscles in the upper lumbar spine
A

Transverse process fracture

27
Q

What is the most common level to experience a transverse process fracture?

A

L3

28
Q

definition: progressive bony fusion of spinal elements and the pelvis

A

ankylosing spondylitis

29
Q

What is the cause of ankylosing spondylitis?

A

autoimmune inflammatory conditions

Genetics

30
Q

What are the s/s of ankylosing spondylitis?

A
  • chronic/dull LBP or SIJ pain
  • loss of lumbar AROM
  • multi-level hypomobility with lumbar and thoracic PA glides
  • loss of rib cage expansion
31
Q

The spinal cord ends between levels __-___.

A

T12-L3

32
Q

What structures does the cauda equina provide innervation to?

A
  • LE
  • bladder
  • anus
  • perineum
33
Q

What causes cauda equina syndrome?

A
  1. herniation of lower lumbar disc (most common)
  2. epidural hematoma
  3. infections
  4. neoplasms
  5. trauma
34
Q

Herniations below T12 will have (UMN/LMN) signs.

A

LMN

35
Q

Herniations above T12 will have (UMN/LMN) signs.

A

UMN

36
Q

Cauda equina syndrome is most common in younger (males/females)

A

younger males

37
Q

What is the clinical presentation of cauda equina syndrome?

A
  • severe LBP
  • bilateral lumbar radiculopathy symptoms
  • bladder/bowel dysfunction
  • saddle anesthesia or loss of sensation around the anus
  • sexual dysfunction
38
Q

What clinical signs should raise suspicion of cauda equina syndrome?

A

saddle anesthesia or loss of sensation around the anus
AND
bladder dysfunction

39
Q

Cauda equina lumbar radiculopathy symptoms normally follow the ____ pattern with weakness and paresthesia

A

L5/S1

40
Q

(LMN/UMN) symptom presentation is more common in cauda equina syndrome.

A

LMN (L3-S1 affected)

41
Q

(true/false) patients who present to PT with s/s of cauda equina syndrome do NOT need to be rushed to the ER.

A

FALSE

42
Q

Finding cauda equina syndrome and decompressing it <____ hours after onset is the window to prevent lasting damage.

A

< 48 hours

43
Q

What diagnostic imaging is the gold standard for detecting cauda equina syndrome?

A

MRI

Musculoskeletal (23 decks)

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