Spine MDT Flashcards
What is radiculopathy
pathologic process affecting the nerve root
The following describes what injury:
- Neck, shoulder, or arm pain
- muscle weakness
- Sensory changes
- Diminished deep tendon reflexes
Cervical Radiculopathy
Pt presents with:
- Neck, shoulder, or arm pain
- Muscle weakness
- Sensory changes
- Diminished deep tendon reflexes
- Headaches
- These features vary by which nerve involved
Cervical Radiculopathy
Pt PE:
- Cervical lordosis may be reduced
- Tenderness to spinous process or paraspinal muscles
- Extension and axial rotation will often reproduce pain symptoms
- Positive Spurling test
Cervical Radiculopathy
Treatment of Cervical Radiculopathy
- Spontaneous resolution of all or most symptoms in weeks to a couple of months
- NSAIDs, Tylenol, muscle relaxers
- PT or Chiropractor (rehab, traction)
The following describes what injury:
- Neck sprain
- Ligamentous, facet joints, muscular, disc injury
- Usually self-limiting
- Commonly from whiplash mechanism
- May be no mechanism of injury
Cervical Strain
Pt presents with:
- Non-radicular, non-focal neck pain from the base of the skull to the cervicothoracic junction
- Worse with ROM
- Paraspinal spasm
- Occipital headaches
- Irritability, fatigue, sleep disturbances, and difficulty concentrating
Cervical Strain
Treatment of Cervical Strain
- Soft cervical collar for 1-2 weeks and reassurance
- NSAIDS and muscle relaxants
- Massage, manipulation, and cervical traction
- Return to activities as soon as possible
Time frame of acute back pain
4 weeks
Time frame of sub acute back pain
4-12 weeks
Time frame of chronic back pain
over 12 weeks
Etiologies of back pain
- Non specific back pain
- Vertebrl compression
- Radiculopathy
- Systemic disease
- Cauda Equina syndrome
Red flags of lower back pain
- Saddle anesthesia
- Loss of bowel/bladder function
- Lower extremity weakness
Treatment of Low Back Pain
- Control pain, reassurance
- Activity/lifestyle modification
- Early mobility (if acute)
- Core stabilization through rehab
Pt presents with:
- Abrupt or gradual onset
- Unilateral radicular leg pain
- Aggravated by various factors
- Possible neurologic involvement
L4-L5, L5-S1 distribution
L1-L4 refers pain to anterior thigh
Herniated disc
Pt PE:
- Weakness depends on affected myotome
- Dorsiflexors, plantar flexors, and extensor hallucis longus
- Numbness depends on affected dermatome
- Knee and Achilles Reflexes
- Heel and Toe Walk
- Positive SLR
Herniated disc
Treatment of Herniated Disc
- Control pain
- Activity/lifestyle modification
- Rehabilitation
- Chiropractic care
When would you MEDEVAC back pain
- Cauda equina syndrome symptoms
- Severe nerve root paralysis
- Radicular symptoms that persist more than 6 weeks without severe symptoms
The following describes what injury:
- Lateral curvature of the spine that is more than 10 degrees in an adult
- May be from spinal degeneration or from childhood
- Mostly minor deviations from normal and asymptomatic
- Symptomatic patients disqualified from service
Scoliosis
How many degrees of lumbar and thoracic scoliosis is considered disqualifying for service?
Lumbar: >20 degrees
Thoracic: >30 degrees
Goals of treatment for Scoliosis
- Improve function
- Quality of life
- Stamina improvement
What is not a realistic goal for treatment of scoliosis
Correction of spinal deformity
