M5 Lumbar Flashcards
A fracture of the Pars Interarticularis is termed:
Spondylolysis
Most common vertebral segment for a pars fracture (spondylolysis)?
L5
__% of isthmic spondylolysis will develop spondylolisthesis
70%
90% of all spondylolistheses involve the __ vertebra
L5
There is a 28-40% prevalence of spondylolistheses in the ___ population, with the involved levels being L1-L3
Eskimo
Type 1 spondy is known as ____
Congenital
A type 2 spondy is called?
Isthmic
Type II Isthmic means what?
Pars fracture
A type 3 spondy is what?
Degenerative
A type 4 spondy is?
Traumatic (fracture other than Pars)
A type 5 spondy is what?
Pathological (underlying disease, ex: Paget’s)
Are disc herniations generally associated with spondylolisthesis?
NO
Two ways to measure a spondylolisthesis on X-ray are ___ line and ____ classification
Ulman’s, Meyerding’s
Pregnancy has/has not been found to be associated with increased risk of anterior displacement (like spondy)
Has NOT
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…)
10
The most common indication for surgery in a person over 60?
Spinal stenosis
How many categories of acquired spinal stenosis are there?
6.
There are __ primary sub-syndromes of spinal stenosis (lumbar)
4
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.
Neurogenic Intermittent Claudication
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.
Cauda Equina Syndrome
A good ortho for lumbar spinal stenosis?
SLR
The weak spot in the disc is located under the ____
Nerve root…
Approximately __% of disc herniations occur at L4-5 and L5-S1
90%
___ in the nucleus pulposus provide stiffness and resistance to pressure
Proteoglycans
Is cauda equina syndrome a medical emergency?
Yes-want to prevent permanent loss of function
___ 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.
Waddell
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.
Facet syndrome
There are 3 classifications of facet syndrome. This one is due to injury and is associated with inflammation to the joint capsule.
Traumatic
This type of facet syndrome is due to degenerative arthrosis of the facet joint. Generally associated with DDD.
Pathologic
This classification of facet syndrome is due to biomechanical changes that place more stress on the facets (chronic)
Postural
A good ortho for lumbar facet syndrome?
Kemp’s test
