Important Spine Concepts Flashcards
What is the nomenclature for disc disease?
commonly used for herniated nucleus pulposus, prolapsed disc, ruptured disc, and torn annulus.
What characterizes a ‘normal’ disc?
Free of disease, trauma, and aging; however many ‘normal’ pain-free backs can have ‘abnormal’ discs.
What is an annular fissure?
Fissures in the annulus due to degeneration, aging, or trauma; seen in many people who do not have low back pain.
What is a bulging disc?
Generalized displacement of the disc tissue beyond the disc space
often a normal variant at L5/S1.
(bulging does not mean there will be symptoms)
What is a herniated disc?
Protrusion where the distance between the edges of the herniation is less than the distance at the edges at the base.
What is a herniated disc extrusion?
The distance between edges of herniation is greater than the distance at the base
often results in nerve root compression.
What is a herniated disc sequestration?
Displaced disc material has lost all connection with the disc of origin
may lead to leg pain only.
can also become reabsorbed
What is Schmorl’s node (intervertebral herniations)?
A portion of the disc projects through the vertebral end plate into the center of the vertebral body
common in minor degeneration of the aging spine.
What are major causes of Cauda Equina Syndrome?
Disc herniation, spondylosis
tumor
compression fractur
infection
ischemia
mechanical causes
What are degenerative diseases affecting the spine?
Disc degeneration, spondylosis, facet arthritis, stenosis, and spondylolisthesis.
What is spondylolisthesis?
The forward slippage of one vertebra over another.
What are the types of spondylolisthesis?
Isthmic (due to pars fracture or defect) common in adolescents
degenerative (most common in people over 65)-often grade 1 or 2
What are the grades of spondylolisthesis?
Grade 1: 0-25%,
Grade 2: 25-50%,
Grade 3: 50-75%,
Grade 4: 75-100%,
over 100% is spondyloptosis.
What is rheumatoid arthritis?
A systemic autoimmune disease diagnosed via blood tests; affects the synovial lining.
What are seronegative spondyloarthropathies?
Includes ankylosing spondylitis, psoriatic arthritis, and irritable bowel disease associated spondyloarthritis.
What is ankylosing spondylitis?
Reactive symptoms of sacroiliac joint pain and stiffness often begin during late adolescence or early adulthood.
diagnosed via xray and blood work
What is spondylolysis?
A congenital defect or non-displaced fracture of the pars interarticularis, usually at L5.
common in children and adolescents
often heals with rest
What are compression fractures?
The most common type of spinal fracture due to osteoporosis, trauma, or tumor.
often felt with a sudden onset of back pain that increases with standing or walking , pain decreases while lying on the back
most common in thoracic-lumbar spine
What is a Jefferson fracture?
A burst fracture of C1, often caused by axial loading; usually does not result in neurologic compromise.
What is discectomy?
The most common procedure for herniated discs; involves removing a portion of or all of the disc.
an ambulatory surgery: avg time is 1-2 hours
What is artificial disc replacement surgery?
An alternative to spinal fusion for disc disease or herniation
typically done for patients wuth disc disease at only one level
What is spinal fusion?
Most commonly performed for spondylolisthesis; involves fusing vertebrae together.
What are kyphoplasty and vertebroplasty?
Minimally invasive techniques to treat compression fractures;
kyphoplasty involves balloon insertion and cement filling.
vertebroplasty is bone cement injected under high pressure
What are common conservative treatments for back pain?
Education, medication, physical therapy, and bracing.
