Lx Spine

Question 1

Posterior facet syndrome

Answer 1

Presents with dull aching LBP
SHARP LOCALIZED LOW BACK PAIN
Onset may be due to trauma, such as twisting
Patient may complain of sensory changes
Pain is relieved by rest and aggravated activity that stress is the facets.

Question 2

Concentric annular tear

Answer 2

Splitting of the annulus fibrosis
Most common in the middle and outer 1/3
Causes pain with torsional load
L5/S1 is more common posterior
in all other end is 50% MC
Lx it is seen anterior and posterior equal

Question 3

Internal disc disruption

Answer 3

Disruption of the internal aspect of the desk without signs of this protrusion
Low back pain felt locally in the midline and may radiate to the SI joint
SLR is frequently impaired
Absent neurological symptoms

Question 4

Discal herniation

Answer 4

90% of disc prolapse occurs at L4/L5 and L5/S1
-Central prolapse is more common in younger patients, if large enough can cause cauda equina.
-Posterior lateral prolapse most common injury, due to weakness of the annulus and lateral margin of PLL typically compressingL4/L5.
-far lateral prolapse is more common in older patients causing compression of the exiting nerve root L4/5

Question 5

L3/4 disc and L4

Answer 5

Low back pain, hip, groin, and anterior leg
Numbness in the anterior medial, thigh, and knee
Weakness/atrophy in the quadriceps
Reflexes in the patella, decrease or absent

Question 6

L4/5 L5 nerve root

Answer 6

Pain over SI joint, hip lateral thigh and leg.
Numbness and lateral leg web of great toe
Weakness with extension of the toe
Medial hamstring reflex and posterior tibial diminished

Question 7

L5/S1 disc S1 nerve root

Answer 7

Pain over SI joint, hip, posterior lateral thigh and lateral foot
Numbness in the back of the calf, lateral heel, foot and toe
Weakness and plantar flexion and walking on toes
Atrophy of the gastrocnemius and soleus
Reflex in the Achilles, decreased or absent

Question 8

Cauda equina syndrome

Answer 8

Men are more common than women
First symptom is disc herniation pain at L5 /S1
Radicular pain in the back, buttocks, saddle area, genitalia, thigh, and leg
Loss in sensation and tingling in Saddle area
Weakness in legs
Bladder, bowel and sexual dysfunction -incontinence of urine and feces
Loss of reflux in the knee ankle

Question 9

NSLB

Answer 9

pain in the lumbar region with no associated radiculopathy or neuropathies