Flashcards in Back/Spine Deck (23)
Majority of acute lower back pain is caused by...
Muscle and/or ligament damage
2 most common types of lower back injury
- Muscle strain
- Lumbar ligament sprain
Is pain from back strain radicular?
Cauda equina syndrome
Large midline disk herniation that compresses nerve roots
Sx of cauda equina syndrome
Severe low back pain w/ B/B incontinence
How to diagnose cauda equina syndrome
Decreased rectal tone
Does cauda equina syndrome require surgery?
YES--surgical emergency, decompression (laminectomy)
Herniated nucleus pulposus: types (2) and which vertebrae are affected
Cervical: usually posterolateral at C5-C6, C6-C7
Lumbar: L5-S1 (most common), L4-L5
Sx of cervical herniated nucleus pulposus
Pain in arm/shoulder, numbness/tingling, pain at rest
How to differentiate between rotator cuff and cervical herniated nucleus pulposus?
Rotator cuff=no pain at rest
Cervical herniated nucleus pulposus=pain at rest
Sx of lumbar herniated nucleus pulposus
Sudden onset pain radiates below knee
Relieved w/ bed rest
Exacerbated by coughing, sitting, straining, straight leg raise
Diagnostic imaging for herniated nucleus pulposus
MRI (noncontrast for lumbar)
Tx of herniated nucleus pulposus
NSAIDs, muscle relaxants, epidural steroids
Chronic inflam progressing to fusion of vertebrae
Does pain of ankylosing spondylitis get worse with activity?
NO, it gets better
What do labs for ankylosing spondylitis look like?
[+] HLA-B27 gene
Increased CRP and ESR
What is typical of ankylosing spondylitis on films?
"Bamboo spine"--squaring of vertebral bodies and loss of curvature
What is the leading dx for pts >65 who have spine surg?
Sx of spinal stenosis
Dull back pain radiating to LE pain w/ walking or wt bearing, relieved by rest
What position relieves pain of spinal stenosis?
"Shopping cart sign"
What can cause progressive kyphosis?
TB of spine (Pott's dz)