questions cours Flashcards
À quelle niveau retrouve-t-on des nodules de Schmorl?
L1-L2 et L2-L3
Quelles sont les 3 structures les plus atteintes dans les lombalgies non spécifiques?
Le disque (25-30 ans le +), les facettes articulaires (60 ans le +) et l’articulation sacro-iliaque (même que facettes)
Quelles sont les niveaus de dégénerescence facettaire les plus atteints?
L4-L5 et L5-S1 (encore plus)
Quelles signes et symptômes clinique nous font penser à une atteinte facettaire?
pas de valsalva, douleur + debout ou marche que assis ou coucher, pas de centralisation, ext fait + mal, flex ne fait pas + mal, limitations des mvts va avec les mvts facettaires
facette mal en fin de flex, disque mal en mi-flex
Causes des lombalgie avec atteinte neuro
ostéophytes, disque, spondylolisthésis
Causes de lombalgie sans atteinte neuro
disque, facette, sacro-iliaque, dure-mère sans neuro, ligaments, muscles
Central Stenosis
Narrowing of the spinal cord space as a result of a space-occupying lesion may lead to spinal cord compression.
The lesion is commonly caused by osteophytes, disc herniation, ligament thickening or calcification, or tumor
Degenerative lumbar joint disease (DJD)
Breakdown of the lumbar spine facet articular surfaces with a resultant loss of cartilage.
Can occur with DDD in which there is a loss of disc height. the breakdown of articular cartilage leads to a resultant inflammatory cascade that can redult in bone spurs or osteophyte formation
Interforaminal stenosis
Loss of interforaminal area.
this narrowing can result in impingement of the nerve root.
the most common sources of lesion that decrease the space are loss of intervertebral disc height, inflammation, osteophytes, disc herniation, ligament thickening, calcification, or tumor.
Lumbar disc pathology
disc herniation or disc bulges are synonymous terms used to describe a condition in which disc material extends beyond the perimeter of the normal disc space
four common classes: protrusion (np bulges outward into the annulus but no damage is done), prolapse (np bulges outward into the annulus and annular lamina are damaged), extrusion (np breaks past the outer annulus and into the space beyond), sequestration (np breaks free of annulus)
slr très sensible
contra lat slr est spécifique
Lumbar instability
excess motion in the lumbar spine segments in which a normal external force or load causes hypermobility and pain.
Excessive motion is defined as an excessive rotational segmental angle or segmental translation greater than 3mm.
Lumbar ligament strain
tearing of the fibers of a lumbar ligament.
if complete, it could lead to a lumbar segmental instability.
a partial tar can be as small as a microtear in the substance of the ligament.
Lumbar muscle strain
microtear of a lumbar muscle or tendon, most commonly at either the z line or the musculotendinous junction.
the most common strain is the erector spinae muscle.
Lumbar radiculopathy
not a cause itself of LBP but a result of another lumbar pathology on the lumbar nerve root(s).
if a lumbar nerve root is impinged or inflammed and causes neuro symptoms, the result is a lumbar radiculopathy.
causes pain, numbness, tingling, and weakness in the lower extremities in the dermatomes/myotomes.
Lumbar spondylolysis/spondilolisthesis
Defect in the pars interarticularis.
If the fracture defect widens and allows the superior segment to slip on the inferior segment, the result is a spondylolisthesis.
means spine slippage, therefore spondylolisthesis refers to a slippage of one spine segment in relationship to its adjacent segment
