Flashcards in Disc Herniations Deck (41)
What is the true definition of a disc herniation?
Projection of nuclear material through the annulus into the canal
Are disc herniations common?
NO; only 5% of back pain patients suffer from disc herniation
What is the gold standard imaging procedure to diagnosis a disc herniation?
How does the pain typically present with a disc herniation?
What is the most common complaint of patients with a disc herniation?
What kinds of activities make the pain of a disc herniation work?
Sneezing, flexion, sitting, bowel movement
What is one of the most serious complications of a disc herniation?
Cauda Equina syndrome (1-16%)
What is cauda equina syndrome?
Compression of multiple nerve roots leading to altered bowel and bladder function, saddle paresthesia, muscle atrophy, and impotence
What neurological test can be used to assess for myelopathy?
What kind of canal can lead to asymptomatic herniations?
Increased canal size
What is the most common treatment for a herniated disc?
What is the most common age range for a disc herniation?
25-40 (which discs are juicy)
A C5/C6 disc herniation would compress which nerve root?
What kinds of symptoms arise from a midline disc herniation in the cervicals?
What kind of directional disc herniation causes nerve route compression below in the cervicals?
What type of disc herniation in the lumbars will compress the nerve root BELOW? The nerve root at the same level?
BELOW = midline/paracentral
SAME LEVEL = foraminal
A L5/S1 foraminal disc herniation will compress what nerve root?
L5 nerve root
A L5/S1 midline disc herniation will compress what nerve root?
Which types of disc herniations in the cervicals is most significant due to the compressive of the nerve root below? Lumbars?
Cervicals = lateral
Lumbars = midline/paracentral
What is the function of the IVD?
What three things must be intact and functional for the IVD to successful work to dampen forces?
1 stability of annulus
2 hydration of nucleus
3 separation offed by endplates
What is the technique used by injecting a water-based or oil-based contrast into subarachnoid space to asses for disc herniations?
What is the technique used by injected radiopaque contrast into the nucleus pulpous to image morphology?
How does discography show a present disc herniation?
Contrast will leak into spinal canal
Why are discography and myelography considered inferior to CT or MRI?
Invasive due to injection
If a disc herniation is visible on CT, what would be the FINDING?
What are the contents of the spinal canal?
1 thecal sac
2 epidural fat
3 internal vertebral plexus
4 ligamentum flavus
What are the MRI findings of a disc herniation?
1 focal bulge
2 obliterated epidural fat
3 deformed theca
4 displaced nerve roots
5 decreased MRI signal
What are the four steps of classification for a disc herniation?