Spine

Question 0

Most common causes of the infectious disorders of the spine

Answer 0

• Staph aureus most common**

- Pseudomonas in IV drug abuse-~Mycobacterium tuberculi =potts disease

Question 1

What are risk factors for embolic infection of the vertebral body metaphysis causing ischemia, infarct and bony destruction with disc involvement?

Answer 1

Advanced age, diabetes, immunodeficiency, penetrating trauma, Jean you procedures, and invasive spinal procedures.

Most commonly seen in the lumbar spine, but increases in cervical region with IV drug abuse and thoracolumbar junction in tuberculosis

Question 2

What are indications for using bracing in vertebral fracture

Answer 2

• Pain relief for acute fractures, spinal immobilization decreases paraspinal muscle spasm and overuse.
• stabilize the spine.
• Prevent further fracture.
• Prevent soft tissue shortening.
• Decrease flexion.
• Compensate for a weak erector spinae muscles

Question 3

What are contraindications to back bracing?

Answer 3

• hiatal hernia
• inguinal hernia
• orthopnea secondary to COPD
• obesity
• kyphoscoliosis

Question 4

What are the risks of prolong use of spinal orthosis?

Answer 4

• Weakening/atrophy of trunk muscles
• reduced spinal mobility
• increased fracture risk due to disuse osteoporosis

Question 5

Lumbar traction amount.

Answer 5

Start at 50% of body weight and increase successively by 5 to 10 pounds which can successfully palliate the symptoms of pain and or parasthesias as well as reduce weakness in the distal myetomal distribution of the compromised spinal root.

Question 6

Facet exercises

Answer 6

Williams flexion or neutral spine

Question 7

How do you start with lumbar traction?

Answer 7

Start with 50% of the bodyweight and increase successively by 5 to 10 pounds until symptoms of pain or paresthesias or palliated

Question 8

What is a good wait for cervical traction?

Answer 8

25 pounds in flexion

Question 9

What muscles make up the transversospinal muscle group?

Answer 9

This is the deep layer of the intrinsic back muscles.

-semispinalis capitis, 
semispinalis  thoracis 
 semispinalis cervices 
multifidus 
rotators
Intertransversarius muscles  
quadratus lumborum

Question 10

Intermediate muscles of the back

Answer 10

Serratus posterior
erector spine
iliocostalis lumborum/thoracis/cervicis
Spunalis thoracis

Question 11

What are Waddell signs significant for?

Answer 11

If three of five signs are present it is clinically significant for likely malingering.

Distraction, overreaction, regionalization, simulation, tenderness