Spine MSK/Pain Flashcards
Steroid that is more likely to cause tissue atrophy with injection of superficial structures?
Triamcinolone
What type of allergy can interfere with hyaluronic acid injections?
bird products (eggs, poultry, feathers)
What are the natural curves of the spine?
- cervical lordosis
- thoracic kyphosis
- lumbar lordosis
- sacral kyphosis
What is “transitional anatomy” in the lumbar spine?
some people have sacralization of the lumbar spine or lumbarization of the sacrum resulting in 4 or 6 lumbar vertebrae respectively.
Does having “transitional anatomy” in the lumbar spine necessarily cause pain or is it a normal varient?
normal varient
What does the nucleus pulposus consist of?
Type II collagen, water, and other materials
What type of collagen makes up the annulus fibrosis?
type I

What nerves innervate the C4-C5 facet joint?
C4 and C5 medial branches of dorsal rami
What nerves innervate the L3-L4 facet joint?
L2 and L3 medial branches of dorsal rami

What provides innervation to the nucleus pulposus?
nothing, it lacks innervation.
What provides innervation to the annulus fibrosus?
- anterior: ventral rami
- posterior: sinuvertebral nerves
What provides innervation to the vertebral body?
sinuvertebral nerves
When is surgery indicated for a vertebral body compression fracture?
- greater than 25% loss of disc height
- spine is unstable
- significant neurologic deficits

What defines the middle column of the spine?
Posterior 1/3 of the vertebral body to the posterior longitudinal ligament

When is a spine unstable?
dammage to the middle column or any 2 columns
How does neurogenic claudication present?
- leg or buttock pain/weakness
- worse with prolonged standing
- worse with spinal extension and relieved with flexion
How does vascular claudication present?
- calf pain worse with activity (walking uphill, biking)
- skin changes (thin, shiny, hairless)
- diminished/absent pulses
Treatement for spinal stenosis
PT with directional preference assessment (flexion biased) or surgical decompression
Most common cause of spondylolisthesis?
Isthmic (Class II): fracture of pars interarticularis

How do you grade spondylolisthesis?

Treatment for spondylolisthesis?
- Grade 1, 2, and asymptomatic grade 3: rest and PT
- Symptomatic grade 3 or grade 4: surgery
What triggers SI joint pain?
transitional movements (sit to stand)
What does bilateral sacroiliitis indicate?
Ankylosing spondylitis
What type of radiculopathy will a L3-L4 central or posterolateral herniation cause?
L4
























