3.3.3 Surgical Approaches to Back Pain

Question 1

What is the classic dermatomal pattern from L1-S2 of the lower extremity?

Answer 1

Question 2

What is going on in the image on the right?

Answer 2

Spinal stenosis

Question 3

What is a radiculopathy?

Answer 3

A nerve root compression

Question 4

What is the gold standard for spine imaging?

Answer 4

MRI - better soft tissue resolution

Question 5

If there is a posterolateral herniation of a disc (impinges medially) which root might be affected by the radiculopathy?

Answer 5

The traversing root

Question 6

What is the clinical triad of cauda equina syndrome?

Answer 6

saddle anesthesia, bowel or bladder dysfunction, and low back pain

Question 7

What is the lifetime incidence of back pain?

Answer 7

70-85% lifetime incidence

Question 8

What are some not surgical approaches to treating back pain?

Answer 8

Question 9

What must be trust regarding imaging/tests and the signs & symptoms?

Answer 9

They must correspond with one another. Need to make sure that the condition has been accurately diagnosed

Question 11

Back pain that wakes them up at night is associated with what type of condition?

Answer 11

Cancer

Question 12

What does HNP stand for?

Answer 12

Herniated Nuclear Pulposus (aka Lumbar Disc Herniation)

Question 13

What is the most common cause of activity limitation in ppl < 45 years?

Answer 13

Back pain

Question 14

Identify the different locations for lumbar HNP

Answer 14

Question 15

What is a myelopathy?

Answer 15

An injury to the spinal cord

Question 16

What are the most common sites of lumbar disc hernation?

Answer 16

L4-5 or L5-S1

Question 17

What are the uses of x-ray in regards to back pain?

Answer 17

R/o fracture and bony destruction from neoplasia, indentify non-specific degenerative processes

Assess disc height