spinal disorders Flashcards
what shape does the spine make
the spine has three natural curves to make an S - Shape
what do the three natural curves of the spine do?
absorb shock and protect the spine from injury
what is the spinal vertebrae and how many are there ?
33 vertebrae
the vertebrae of the spine forms the spinal canal; this houses the spinal cord and its nerves and protects them from injury
what are the CARTILAGE spinal joints of the spine called
facet joints
function of the facet joints
connections between the
bones of the spine
what passes through the facet joints to travel from the spinal cord to other body parts
nerve roots
what opening does the nerve root exit from of the spinal cord to reach the body?
the spinal canal
what are intervertebral discs?
discs between each vertebrae and act as the spine’s shock absorbers.
what are the soft tissues of the spine and what do each of the 3 aid in?
soft tissues include ligamenets, muscles and tendons.
Ligaments connect the vertebrae to hold the spine in position.
- Muscles support the back and help you move.
- Tendons connect muscles to bone and aid movement.
the spinal vertebrae are split up into 5 segments called ?
cervical 1-8
thoracic 1- 12
lumbar 1-5
saccral 1-5
coccygeal 1/2
what is spinal dysraphism
congenital spinal disorders affecting the spine, spinal cord, or nerve roots.
dysraphism means = incomplete fusion
spina bifida oculta (hidden/closed)
- mild type
- small gap in spine
- due to incomplete bone
formation during pregnancy. - assymptomatic at times, HOWEVER, maybe:
1. patch of hair or
2. red mark at the base of spine.
Spina bifida open:
there are two types, which are called ?
- Meningocele
- Myelomeningocele
spinal bifida open: MENINGOCELE
what is meningocele?
- spinal fluid filled sac pushes through gap
- skin over sac is open
- spine is in its normal place in the spinal canal
spinal bifida open: mylomeningocele
what is myelomeningocele?
- most severe
- fluid filled, meninges filled, nerve roots filled sac pushes through the gap in the spine AND THE SKIN
- visible on the baby’s
back
types of spinal curve disorders ?
- lordosis ( normal curvature of spine)
- kyphosis
- scoliosis
main 2 symptoms of spinal curve disorders ?
discomfort and pain
what is lordosis ?
Lordosis is a natural curve in the neck
or lower back.
types:
lumbar lordosis
cervical lordosis
what is kyphosis?
excessive curvature of the thoracic spine.
an excessive curvature of the thoracic spine ( kyphosis ) can be seen in what condition in young pp’s ?
Such problems occur at a young
age with Scheuermann’s disease,
also called Scheuermann’s
kyphosis,
what is scoliosis ?
an abnormal lateral curvature of the spine
types of scoliosis ?
thoracic scoliosis
lumbar scoliosis
thoraco-lumbar scoliosis
combined scoliosis
causes of scoliosis ?
80% - idiopathic
or,
degeneration of the spinal discs
e.g. arthritis, osteoporosis or as
a hereditary condition.
What is Spondylolisthesis
- spine instability
- vertebrae moves more than they should.
- A vertebra slips out of place onto the vertebra below.
- pressure on nerve
- causing lower back pain or leg pain
symptoms of spondylolisthesis
lower back pain
leg pain
diffuse weakness ass. with prolonged standing or walking
tx of Spondylolisthesis?
surgery:
spinal fusion – the slipped vertebra is joined to the bone below with metal rods, screws & bone graft
lumbar decompression – a procedure to relieve pressure on the compressed spinal nerves
what is spinal arthritis ?
inflammation of facet joints in spine
or
inflammation of sacroiliac joints between spine and pelvis
the most common type of arthritis ?
osteoarthritis
what is osteoarthritis?
the cartilage within a joint begins to break down and the underlying bone begins to change.
cause of OA
-Joint injury
– overusing a joint when it
has not had enough time to heal
- Secondary causes e.g. gout.
what is Ankylosing
Spondylitis
- chronic inflammation
- inflammation in the joints and ligaments of the spine
signs of ankylosing spondylitis ?
the joints and ligaments help us move and bend. In A.S, after some time, stiffness begins to present itself.
pp’s with A.S may develop what other disease?
plantar fascilitis
causes pain in the heel or arch of the foot.
symptoms of AS ?
fever
fatigue
pain in jaw
pain in ribcage when exhaling
chronic pain and stiffness of lower back
diarrhea
bloating
pain gets worst with inactivity
pain releaves after hot shower
uveitis/eye redness
psorasis
buttock pain
plnatar fascilitis
AS treatment
NO CURE
- exercise, physiotherapy, pain medication
what is lumbar spinal stenosis ?
narrowing of the spinal canal in your lower back
RF
aging
Mostly affecting people above
the age of 60.
symptoms of lumbar spinal stenosis
mostly assymptomatic but
lower back pain
cramping in one or both legs
This happens when you stand for a long time or when you walk. Symptoms get better when you bend forward or sit. Some people also have back pain.
dx test
xray
ct
mri
tx
nsaids
anti-depressants - help ease chronic pain
physical therapy
steroids
surgery: Laminectomy - This surgery removes the back part (lamina) of the affected spinal bone. This eases pressure on the nerves by making more space around them
what is spinal meningitis
infection of the
fluid and membranes around the brain
and spinal cord.
symptoms of spinal meningitis?
- severe headache
- photophobia
- neck stiffness
- red/purple rash
- nausea/vomiting
- cold hands and feet
diagnosis of spinal meningitis ?
lumbar puncture and CSF analysis
what is lumbar puncture
CSF sample
removal of CSF from L3/L4 to avoid nerve damage
to check for infection, inflammation, and other diseases
what does CSF analysis show in encephalitis ?
CSF in viral encephalitis shows
a lymphocytic pleocytosis with normal
glucose and normal or mildly raised
protein.
what is pott disease?
- tuburculosis of the spine (mostly lower thoracic and lumbar )
- tuberculous arthritis of
the intervertebral joints. - due to hematogenous spread from other sites
types of disc disorders
- Disc degeneration disease
- Disc herniation disease
- Thinning of the disk disease
- Bulging disc disease
Disc degeneration disease (DDD)
- what is it
- rf
- ass. with what
- disks start to lose structure and
function gradually. - aging
- Also associated with an injury to the back.
there are 4 stages of DDD ( disc degeneration disease) what are they?
1- Dysfunction stage- loss of natural
curvature.
2- Dehydration stage- degradation
becomes more noticeable as discs start thinning.
3- Stabilisation stage- more pain and
loss of mobility.
4- Collapsing stage- Most severe and
irreversible.
disc herniation is?
soft cushion of tissue between the bones in the spine pushes out of place.
symptoms of disc herniation
lower back pain
neck pain
difficulty bending over
radiating pain below the knee
worst back pain with coughing, valsalva, bending foward
can cause cauda equina
what are the 4 stages of herniated disc disease?
- degeneration/bulding
- protusion / prolapse
- extrusion
- sequenstration
types of disc herniations (2)
Hansen type I
Hansen type II
types of spinal truamas ?
Jefferson fracture
Odontoid fracture
Hangmans fracture
Jumped facets
Compression fracture
Burst fratcure
Chance fracture
Fracture-dislocation
tumors of the spine
Extradural tumours
Metastatic tumours
Intradural extradural tumours
- schwannoma
- neurofibroma
- Ependymoma
- Astrocytoma
- other:
diagnostic test for both fracture and spinal tumour
xray
mri
ct
angiography
Myelography (to determine location)
Electromyography and nerve conduction studies.
treatment for spinal disorder
eIce or heat therapy for injuries.
Injections (such as corticosteroids
or nerve blocks) for pain.
anti-inflammatories
pain relievers
muscle relaxers
Radiation therapy,
radiosurgery,
chemotherapy.
Type of surgery required varies significantly:
Interspinous process devices (IPD).
Spinal Fusion.
Minimally Invasive Spinal Surgery.
Arthroplasty/Motion Preserving Surgery.
Complex Spinal Reconstruction.
Spinal laminectomy/spinal decompression.
Discectomy.
Foraminotomy.
Nucleoplasty, also called plasma disk decompression.
Artificial disk replacement
Stereotactic
radiosurgery
Delivery of high dose radiation
Affective against cancer, epilepsy,
trigeminal neuralgia and arteriovenous
malformations.
what is spinal stenosis
narrowing of the
space within the spine
through which nerves
travel that can put
pressure on the nerves.
degenerative diseases
older indivudals
hypertrophy of facet joints and ligamentum flavum
pain increases on acitivity, walking downhill/stairs
pain releived when sitting, crouched, leaning foward on a cart
what is syringomyleia?
fluid-filled cyst (syrinx) within the spinal cord.
Accompanying pain, weakness, loss of
reflexes, stiffness
Chiari malformation. Other
causes include spinal cord
tumors, injuries and damage caused by inflammation around your spinal cord.
what is Arachnoiditis
inflammation of arachnoid
symptoms of Arachnoiditis
pain
Tingling, numbness or weakness in the legs
Strange sensations like the feeling of insects crawling on the skin
or water trickling down the leg
Bladder and bowel problems
The main causes of Arachnoiditis include:
Trauma or surgery-induced (Arachnoiditis can be a rare
complication of spinal surgery )
Chemically-induced.
Infection-induced— viral and fungal meningitis or tuberculosis.
what is transverse myelitis
inflammation (swelling) of the spinal cord; damage of the myelin sheath.
what is Conus medullaris
The bundle of nerves at the end of spinal cord is known as conus medullaris. Situated between first two lumbar vertebrae and cauda equina. Consequently, problems with the conus medullaris often affect the cauda equina.
bilateral
motor weakness
motor radiculitis
numbness
early incontinence
cauda equina
nerve roots in lumbar spine are compressed cutting off sensation and movement. These nerve roots provide the ability to move and feel sensation in the legs and the bladder.
what is ALS?
neurodegenrative disease in which a persons brain loses connection with their muscles.
loss of bulbar and limb function
they eventually lose the ability to walk, talk, eat and eventually breathe
