Thoracic Lumbar Spine Flashcards
Why is percussion used during physical exam for thoracolumbar complaints?
- ID discrete fx (low sensitivity, mod specificity)
- pain points
- SI joint
Differential Dx for Thoracic Spine Complaint
compression fx, osteomyelitis, muscle spasm, strain/sprain, other SD, extra-thoracic cause
Differential Dx for Lumbar Spine Complaint
compression fx, osteomyelitis, muscle spasm, strain/sprain, other SD, extra-lumboric cause
Why is it important to ID early onset scoliosis by a certain age? What age is this?
10 yo, children under 10 are still growing, scoliosis can be treated more easily at this age, scoliosis if not detected can lead to other problems (ex: malformed ribs -> poor lung development)
What is the most common form of scoliosis? Describe it.
Adolescent idiopathic (AIS) affects 4/100 children age 10-18, 10% require tx, need for tx 10x higher in females
Define scoliosis and diagnostic criteria
Curvature of the spine in the coronal plane with cobb angle greater than 10 degrees
Describe degenerative scoliosis and its causes.
AKA “de novo”, occurs in adults
Causes: progression of childhood scoliosis, secondary (ie trauma)
How do we screen for scoliosis?
- Asymm arm length
- Asymm waist line
- Head not over sacrum (trunk shift)
- Plumb line test
- Forward bending test
Differentiate btw:
- spondylolysis
- spondylolisthesis
- spondylitis
- spondylosis
- stress fx vertebral arch (L5 most common)
- vertebral bodies slipped over one another
- inflamm spine
- degenerative intervertebral disks
List Tx for Scoliosis
- Observation
- Braces
- Surgery (angle 39-50)
What Cobb angle is considered to be above surgery for scoliosis?
50
Timeline for acute LBP vs. subacute LBP
acute - less than 6 weeks
subacute- over 6 weeks to 3 months
Red flag sx w back pain (often w cauda equina)
- progressive sensory motor deficit
- saddle anesthesia
- difficulty urinating
- fecal incontinence
more red flags on slides
