BONE AND CONNECTIVE TISSUE DISORDERS 1.2 (AB) Flashcards
(112 cards)
“What is spondylolysis?”
A defect in the pars interarticularis, often caused by repetitive hyperextension stresses.
“What part of the vertebra is affected in spondylolysis?”
The pars interarticularis.
“What is the main cause of spondylolysis?”
Repetitive hyperextension stresses that transmit compressive forces to the pars interarticularis.
“What types of stress fractures are seen in spondylolysis?”
Unilateral or bilateral stress fractures, which may lead to pseudoarthrosis.
“What is pseudoarthrosis in spondylolysis?”
A false joint that forms when a stress fracture does not heal properly, allowing abnormal motion.
“What sports are commonly associated with spondylolysis?”
Gymnastics, football (interior linemen), weightlifting, and wrestling.
“What are the clinical manifestations of spondylolysis?”
Mechanical low back pain that may radiate to the buttocks, with or without hamstring spasm; neurologic symptoms are rare.
“Can spondylolysis be asymptomatic?”
Yes, it may be found incidentally on imaging.
“What physical exam findings are associated with spondylolysis?”
Discomfort with spinal extension or hyperextension, tenderness over the affected vertebra, and pain provoked by maintaining extension.
“What provocative test is used for spondylolysis?”
Keeping the spine extended for 10-20 seconds to see if back pain is reproduced.
“What is spondylolisthesis?”
Forward slippage of one vertebra on another.
“What percentage of the population has spondylolisthesis?”
Approximately 4-5%.
“What are the main causes of spondylolisthesis?”
Dysplastic/congenital, isthmic (due to pars stress fracture), traumatic, and neoplastic.
“What are the most common types of spondylolisthesis in children and adolescents?”
Dysplastic and isthmic.
“What percentage of patients with spondylolysis develop spondylolisthesis?”
Between 5% and 15%.
“What neurologic symptoms can occur with spondylolisthesis?”
Radiculopathy and, in severe cases, cauda equina syndrome with bowel/bladder dysfunction.
“What physical exam findings are associated with high-grade spondylolisthesis?”
Loss of lumbar lordosis, flattening of the buttocks, and a vertical sacrum due to posterior pelvic rotation.
“What is the preferred imaging modality for spondylolysis and spondylolisthesis?”
High-quality AP and lateral radiographs of the lumbar spine.
“What additional radiographic view can help diagnose spondylolysis?”
Oblique radiographs.
“What is the ‘Scotty dog’ sign?”
A radiographic finding where the posterior elements of the lumbar spine resemble a dog, and a pars defect appears as a ‘collar’ on the dog’s neck.
“What is the initial management for asymptomatic spondylolysis?”
No treatment is required.
“What is the initial management for symptomatic spondylolysis?”
Activity modification, core-strengthening physical therapy, and anti-inflammatory medication.
“What medications can be used for pain management in spondylolysis?”
NSAIDs such as mefenamic acid, celecoxib, and Alaxan®.
“What is the role of lumbosacral orthosis in spondylolysis treatment?”
Immobilizes the spine in slight flexion to relieve stress on the posterior elements, potentially speeding up symptom resolution.
