Trigger - Neck and back Flashcards
what are indications for a lumbar XR in acute lower back pain
- significant trauma
- atypical pain (?)
- nocturnal pain
- night sweats
MCC of lost work time and disability in young adults. Also MC strained area of the body.
acute lower back pain
associated stiffness is a hallmark finding for what
chronic LBP
fracture of the base of odontoid is considered what type of C2 fracture classification
which fractures are most/least stable
Type 2 is the answer. this has high risk of non-union
type 1 - fx of upper odontoid peg (rare and unstable)
type 2 - fx of base of odontoid (unstable, high risk of non-union)
type 3 - through odontoid and into lateral masses of C2 (best prognosis)
what is the initial care of a cervical strain
- soft cervical collar, mild narcotic and/or NSAIDs x 1-2wks
- muscle relaxers if muscle spasm
- cervical pillow
usually resolved in 4-6 wks but can take up to 12
what test indicates Indicates a long-tract spinal cord lesion
ankle clonus and babinski!!
babinski could also indicate upper motor neuron lesion
what are waddell’s tests and how many must be positive to indicatelow likelihood of success w injections/surgical intervention
- superficial tenderness (marked pain w light touch over lumbar spine)
- axial loading (increased lumbar pain w downward pressure on pts head)
- distraction test (no pain w seated SLR while pt is distracted)
- regional disturbanecs (nonanatomic sensory/motor impairement)
3/4 = low likelihood of help w steroids or sugery
bilateral fractures of the pedicles r pars interarticularis on C2 is known as what
hangmans fx
where is the Odontoid (dens) fracture
C2
how would nerve root impingement and spinal crod injury both present differently in a patient with cervical spine fractures
- nerve root impingement = focal UE numbness/tingling
- Spinal cord injury = global sensory/motor deficits
gap or step off between spinous processes suggests what
- fracture of the pars of the vertebre
- ligamentous injury
what are signs of instability on a cervical XR
- translocation of a vertebral body >3.5mm
- 11 degrees of angulation of adjacent vertebral bodies
what is used for symptom relief in an isolated transverse process fracture of the thoracic or lumbar spine
thoracolumbar corset
when do we use Thoracolumbosacral orthosis (TLSO) for 8-12 weeks
- stable, simple compression fractures <20 degrees
- also use oral narcotics for pain at this point
what is the treatment for severe thoracolumbar vertebral fractures?
burst fx, severe compression fx, flexion-distraction/dislocation
sugrical decompression