Spine/back pathologies

Question 1

Diagnosis of intervertebral disk pathology

Answer 1

MRI - gold standard
- CT discogram, clinical exam

Question 2

intervertebral disc pathology
causes

Answer 2

• high compressive forces/repetitive movements
• ex construction, manual labor, factory workers

Question 3

intervertebral disc pathology
signs/ sxs

Answer 3

• arm or leg pain (arm for cervical spine, leg for lumbar spine)
• deep, achy pain
• pain inc with movement, pain referred
• pain in butt, thigh, calf, part of foot
• radiating pain with cough, sneeze, move in certain positions
• numbness/tingling
• weakness
• follow myotomes and derms of affected N

Question 4

intervertebral disc pathology
bulge directions

Answer 4

• lumbar spine - posterolat - where spinal nerve comes out and where annulus is weakest
• can affect cauda equina if lumbar central disk path
• central disc bulges can occur in cerv spine and can cause hyperreflexia/SC pathology

Question 5

4 types of disc herniation

Answer 5

-protrusion - comes out a little, still contained in annulus
-prolapse - some fibers still contained in annulus
-extrusion - annulus fibers disrupted, come out of borders of disc
- sequestration - free/floating matter of nuculus pulposus

Question 6

How are C-spine nerves affected in regards to herniation and stenosis?

Answer 6

• C spine nerves: always exit above vertebra: ex C4 btw C3-C4
• disc herniation: disc C5-C6, nerve compressed C6
• stenosis - C5-C6 - nerve compressed C6

Question 7

How are lumbar spine nerves affected in regards to herniation and stenosis?

Answer 7

• nerve exiting: nerve exits above vert level - ex L4 exits btw L4-L5
• with stenosis - nerve exits above level: ex L4 gets compressed btw L4-L5
• with disc herniation: nerve gets compressed below disc level: L5 gets compressed between L4-L5

Question 8

muscle strain
age, presentation, pain aggravation, test

Answer 8

• age: 20-40
• unilateral
• acute onset
• pain: standing increases , sitting decreases, stretching increases
• • plain x ray

Question 9

herniated nucleus pulposus
age, pain aggrivators, onset, tests

Answer 9

• 30-50 y/o
• back and unilateral leg
• acute onset
• standing decreases pain
• sitting increases pain
• bending increases pain
• • SLR
• • plain xray

Question 10

osteoarthritis
age, pain presentation/ aggrivators
tests

Answer 10

• > 50 y/o
• unilateral
• insideous onset
• increased with standing
• decreased with sitting
• decreased with bending
• negative SLR
• • plain xray

Question 11

spinal stenosis
age, pain presentation/ aggrivators
tests

Answer 11

• > 60
• bilateral leg pain
• insideous
• standing increase pain
• sitting decrease pain
• bending decrease pain
• +SLR
  = + plain xray

Question 12

spondylolisthesis
age, pain presentation/ aggrivators
tests

Answer 12

• 20 y/o
• insidious onset
• pain increase with standing
• pain decrease with sitting
• pain increase with bending
• • SLR
• +plain xray

Question 13

scoliosis