Thoracic and Lumbar Spine

Question 1

Inspection of T/L Spine

Answer 1

Gait
Posture
Curve-> Thoracic: convex Lumbar: concave
Skin-> lesions or trauma

Question 2

Percussion

Answer 2

id discrete areas of fracture and pain points
gentle then more intense
SI joint

Question 3

Auscultation

Answer 3

used to see if other symptoms are associated with specific back complaint

Question 4

Thoracic Spine Differentials

Answer 4

• Compression fracture
• Osteomyelitis
• Muscle spasm
• Strain/sprain

Question 5

Lumbar Spine Differentials

Answer 5

• Compression fracture
• Osteomyelitis
• Muscle spasm

Question 6

Scoliosis subtypes

Answer 6

-Congenital
-Early Onset: <10 can affect other areas ex ribs
-Adolescent Idiopathic: most common
IMP to treat as early s possible

Question 7

Cobb Angle for Scoliosis

Answer 7

needs to be >10 degrees

Question 8

Do females or males have higher risk of curve progression?

Answer 8

females

Question 9

Scoliosis Adult causes

Answer 9

• de novo (degen) scoliosis
• secondary to another condition
• adult spinal deformity

Question 10

Screening for Scoliosis

Answer 10

• difference height of shoulders
• asymmetry of waistline
• trunk shift: head shifted to one side
• forward bending test

Question 11

Spondylolysis

Answer 11

stress fracture in pars interarticularis

-majority at L5

Question 12

Spondylolisthesis

Answer 12

one vertebral body slipped forward

-often caused by spondylolysis

Question 13

Spondylitis

Answer 13

inflammation of spinal joints

Question 14

Spondylosis

Answer 14

degeneration of intervertebral discs

Question 15

Scoliosis Treatment

Answer 15

1. observation
2. bracing dep on Cobb angle
3. Surgery: angle >39-50
   
   • > 50 is above surgical threshold

Question 16

Cauda Equina Syndrome

Answer 16

EMERGENT

• saddle anesthesia
• bilateral sciatica or leg weakness
• incontinence

Question 17

Red Flag Findings for Spinal Pathology

Answer 17

-fever
-IV drug use
- previous steroid use
-

Question 18

Sensitivity and Specificity of Compression Fracture

Answer 18

• > 50 years sensitivity 84% specificity 61%
• trauma sensitivity 30% and specificity 85%
• corticosteroid use sensitivity 6% and specificity 99.5%

Question 19

Sensitivity and Specificity of herniated disk symptom of Sciatica

Answer 19

-Sensitivity 95% and specificity 88%

Question 20

Sensitivity and Specificity of Spinal Stenosis

Answer 20

• pseudoclaudication sensitive 60%

- age >50 sensitivity 90% and specificity 70%

Question 21

Sensitivity and Specificity of Ankylosing Spondylitis

Answer 21

• age onset <40 yrs sens 100% specif 7%
• pain not relieved supine sens 80% specif 49%
• morning back stiff sens 71% specif 54%

Question 22

What suggests sciatica or pseudoclaudication

Answer 22

pain radiation below knee compared to posterior thigh