Pathoanatomical Sources of LBP Flashcards
What are the abnormal stresses that will cause a fracture?
Acute fracture and stress fracture
What normal stresses may cause fracture on unhealthy bone?
‘relative’ trauma to bone
osteoporosis
What is the pain description a pt may give when suspecting spinal fracture?
- significant, persistant, “deep” pain in the bone
- severe/unstable fx - radicular symptoms or cauda equina symptoms
What are some physical exam signs that may come up when suspecting spinal fracture?
- painful splinting with P/AROM, wt bearing, etc.
- Palpation: pain on ‘both sides’ of the bone
- sensitive to vibration
What type of fracture is this?
- Common in thoracic and lumbar spine
MOI - ‘compressive’ mechanism
- ‘relative trauma’
Vertebral Compression Fracture
Which Grade of Vertebral Compression Fracture is this?
- 0 - 20/25% reduction in vertebral height (ant/mid or post)
Grade 1 - Mild
Which Grade of Vertebral Compression Fracture is this?
- 20 - 40% reduction in vertebral height
Grade 2 - Moderate
Which Grade of Vertebral Compression Fracture is this?
- > 40% reduction in vertebral height
Grade 3 - Severe
What is ‘true’ spinal instability?
- trauma or severe pathology
- requires medical intervention to stabilize
What is the following a definition of?
- Degenerative changes in IVD, any aspect of the joint, degenerative joint disease, osteoarthritis
- defect in the pars interarticularis of a vertebra
Spondylosis
What is the following a definition of?
Region the inferior and superior articular process
Pars Interarticulatirs
What is the following a definition of?
foward ‘slipping’ or anterior displacement of one vertebral body in relation to the vertebral body immediately below it due to bilateral pars defect
Spondylolisthesis
Which type of spondylolisthesis is this?
Congentital spondylolisthesis
Type I
Which type of spondylolisthesis is this?
- Isthmic Spondylolisthesis
- ‘classic’ presentation od adolescent patient
Type II
Which type of spondylolisthesis is this?
Degenerative spondylolisthesis
Type III
Which type of spondylolisthesis is this?
Traumatic Spondylolisthesis
Type IV
Which type of spondylolisthesis is this?
Pathologic Spondylolisthesis
Type V
What is the following a definition of?
Backward displacement of one vertebra on the other
Retrolisthesis
What is the following a definition of?
Gradual progression of disc degneration and articular cartilage mechanical breakdown
Osteoarthritis
What are osteophytes referred to as?
Bone spurs
What is the following a definition of?
Spinal nerve root impingment due to space occupying lesion in vertebral canal of IVF
Radiculopathy
What are the causes of radiculopathy
- Disc pathology
- Bone pathology of vertebra
What are the most common nerve roots involved in Radiculopathy from HNP?
L5 - S1 radiculopathy followed by L4
What are the following symptoms of?
- c/o LE pain/paresthesia along nerve root pattern
- may or may not have back pain
- coughing, sneezing (valsalva maneuver) provoke pain
- worse with trunk flexion
- c/o weakness - muscle weakness supplied by nerve root
Radiculopathy from HNP
What is the following a definition of?
- outer 1/3 of annulus is innervated
- torision + flexion can injure annulus
- radial fissures that develop in the inner 2/3 of annulus reach outer 1/3
- radial fissuring in the annulus precedes disc prolapse
- prolapse can occur gradually with reptitive overload
- chemical irritation of the nerve root leads to radicular pain
Discogenic Pain
What has this pathology?
- Degenerative changes of disc
- Fissures devlop
- Reduced ability to maintain fluid flow
Degnerative Disc Disease
What mechanical consequences is this?
- reduced ability to absorb compressive forces
- abnormal mechanical stress of on posterior structure (facet jt)
Degenerative Disc Disease
What is the following a definition of?
narrowing of vertebral canal and/or intervertebral foramen (IVF)/neuroforamen
Spinal Stenosis
