Chapter 26: Recognizing Some Common Causes Of Neck And Back Pain

Question 1

Where does the anterior longitudinal ligament of the spine connect?

Answer 1

anterior surfaces of vertebral bodies

Question 2

Where does the posterior longitudinal ligament of the spine connect?

Answer 2

posterior surfaces of vertebral bodies

Question 3

Where does the ligamentum flavum ligament of the spine connect?

Answer 3

laminae of adjacent vertebral bodies and lies in posterior portion of spinal canal

Question 4

Where does the interspinous ligament of the spine connect?

Answer 4

between spinous processes

Question 5

Where does the supraspinous ligament of the spine connect?

Answer 5

tips of spinous processes

Question 6

What is the study of choice to evaluate the spine?

Answer 6

MRI

Question 7

What are some common causes of back pain?

Answer 7

muscle and ligament strain
herniation of an intervertebral disk
degeneration of an intervertebral disk
arthritis involving the synovial joints
compression fractures
trauma to the spine
malignancy

Question 8

Where do most herniated discs occur?

Answer 8

posterolaterally in the lower cervical or lower lumbar spine

Question 9

What is postlaminectomy syndrome?

Answer 9

persistent pain in the back or legs following spine surgery

Question 10

What can detect the cause of postlaminectomy syndrome?

Answer 10

Gadolinium-enhanced MRI

Question 11

What causes degenerative disk disease?

Answer 11

nucleos pulposus dehydrates and degenerates with increasing age

Question 12

What are the facet joints subject to?

Answer 12

osteoarthritis

Question 13

What is facet osteoarthritis frequently associated with?

Answer 13

degenerative disk disease and radicular pain

Question 14

How does Diffuse idiopathic skeletal hyperostosis manifest?

Answer 14

thick, bridging, or flowing calcification/ossification of the ant. longitudinal ligament

Occurs in men over the age of 50

Disk spaces and facet joints are preserved

Question 15

What are compression fractures caused by and who gets them more commonly?

Answer 15

Secondary to osteoporosis and women

Question 16

Can compression fractures be seen on xrays?

Answer 16

YES

Question 17

What do compression fractures usually produce that can be seen on a Xray?

Answer 17

Involve the anterior portion of the body disproportionately causing exaggerated kyphosis in the thoracic spine

Question 18

What is spinal stenosis and where is it most common?

Answer 18

Narrowing of the spinal canal or neural foramina

Most commonly seen in cervical or lumbar regions

Question 19

Where are metastatic lesions to the spine most common?

Answer 19

Blood rich posterior aspect of vertebral bodies - especially Pericles

Question 20

What metastases are most commonly associated with the spine?

Answer 20

Lung
Breast
Prostate

Question 21

Does multiple myeloma involve the spine and if so, what is it associated with?

Answer 21

YES

Severe osteoporosis = compression fractures
Lyric destruction of the vertebral body

Question 22

What are important landmarks connecting the lateral cervical spine on Xray and what do they assess?

Answer 22

Three parallel white lines

These lines assess for fracture os subluxation before the patient is moved

Question 23

What is a Jefferson fracture?

Answer 23

Fracture of C1 commonly seen on Xray as bilateral, lateral fractures offset of the lateral masses of C1

Doesn’t cause neurological deficit

4 fractures in all are produced

Question 24

What is a hangman’s fracture?

Answer 24

Fracture of the posterior elements of C2

Caused by hyperextension-compression injury

Doesn’t cause neurological deficits

Question 25

What is a burst fracture?

Answer 25

High-energy axial loading injuries occurring in the cervical, thoracic, or upper lumbar spine

Bony fragments are seen in posterior spinal canal and anterior vertebral body displaced forward

Neurological Deficits occur

Question 26

What is a chance fracture?

Answer 26

Transverse fractures through the entire vertebral body, pedicles, and spinous process

Occur in upper lumbar-lower thoracic spine

Question 27

What are locked facets?

Answer 27

Occur due to hyperflexion injury

Inferior facets of one vertebral body slide over and in front of the superior facets of the body below

Question 28

How will locked facets appear on a lateral Xray of the spine?

Answer 28

Inferior articular facets will lie in front of the superior facets of the body below

Question 29

What is the naked facet sign?

Answer 29

Occurs in locked facets when the superior articular facets are no longer covered by the inferior facets