M5 Lumbar

Question 1

A fracture of the Pars Interarticularis is termed:

Answer 1

Spondylolysis

Question 2

Most common vertebral segment for a pars fracture (spondylolysis)?

Answer 2

L5

Question 3

__% of isthmic spondylolysis will develop spondylolisthesis

Answer 3

70%

Question 4

90% of all spondylolistheses involve the __ vertebra

Answer 4

L5

Question 5

There is a 28-40% prevalence of spondylolistheses in the ___ population, with the involved levels being L1-L3

Answer 5

Eskimo

Question 6

Type 1 spondy is known as ____

Answer 6

Congenital

Question 7

A type 2 spondy is called?

Answer 7

Isthmic

Question 8

Type II Isthmic means what?

Answer 8

Pars fracture

Question 9

A type 3 spondy is what?

Answer 9

Degenerative

Question 10

A type 4 spondy is?

Answer 10

Traumatic (fracture other than Pars)

Question 11

A type 5 spondy is what?

Answer 11

Pathological (underlying disease, ex: Paget’s)

Question 12

Are disc herniations generally associated with spondylolisthesis?

Answer 12

NO

Question 13

Two ways to measure a spondylolisthesis on X-ray are ___ line and ____ classification

Answer 13

Ulman’s, Meyerding’s

Question 14

Pregnancy has/has not been found to be associated with increased risk of anterior displacement (like spondy)

Answer 14

Has NOT

Question 15

Children under __ should be limiting physical activities for fear of further slippage in spondy cases, while over this age they can do what they want without much worry….(according to our notes…)

Answer 15

10

Question 16

The most common indication for surgery in a person over 60?

Answer 16

Spinal stenosis

Question 17

How many categories of acquired spinal stenosis are there?

Answer 17

6.

Question 18

There are __ primary sub-syndromes of spinal stenosis (lumbar)

Answer 18

4

Question 19

This sub-syndrome of lumbar spinal stenosis is the most common symptom. Pain in the buttocks, thighs, and legs brought on by prolonged standing or exercise in the standing position.

Answer 19

Neurogenic Intermittent Claudication

Question 20

This sub-syndrome of lumbar spinal stenosis is due to massive lumbar disc prolapse. There is bilateral leg pain and neurologic symptoms. There is genitourinary dysfunction. Could have loss of rectal sphincter tone sometimes accompanied by fecal incontinence.

Answer 20

Cauda Equina Syndrome

Question 21

A good ortho for lumbar spinal stenosis?

Answer 21

SLR

Question 22

The weak spot in the disc is located under the ____

Answer 22

Nerve root…

Question 23

Approximately __% of disc herniations occur at L4-5 and L5-S1

Answer 23

90%

Question 24

___ in the nucleus pulposus provide stiffness and resistance to pressure

Answer 24

Proteoglycans

Question 25

Is cauda equina syndrome a medical emergency?

Answer 25

Yes-want to prevent permanent loss of function

Question 26

___ signs are more likely to be demonstrated by patients with work related injuries or patients in litigation related to their injury. They include positive results on simulated tests. The feeling of overreaction during the exam.

Answer 26

Waddell

Question 27

This is brought on by mechanical assaults to the facet joint surface(s) resulting in pain and stiffness. It may simulate a disc lesion. Pain increases particularly with extension. Pain is not exacerbated by coughing or sneezing.

Answer 27

Facet syndrome

Question 28

There are 3 classifications of facet syndrome. This one is due to injury and is associated with inflammation to the joint capsule.

Answer 28

Traumatic

Question 29

This type of facet syndrome is due to degenerative arthrosis of the facet joint. Generally associated with DDD.

Answer 29

Pathologic

Question 30

This classification of facet syndrome is due to biomechanical changes that place more stress on the facets (chronic)

Answer 30

Postural

Question 31

A good ortho for lumbar facet syndrome?

Answer 31

Kemp’s test