Lumbar Conditions Flashcards
(33 cards)
What is mechanical back pain?
Pain when the spine is loaded - sitting/standing
What can worsen mechanical back pain?
Exercise
What can predispose you to mechanical back pain?
Overweight
Unhealthy lifestyle
Deconditioned core muscles
What are age related changes to the lumbar spine?
Nucleus pulposus dehydrated with age
Loss of disc height -> disc bulge
Change in load stresses on discs -> reactive marginal osteophytosis next to affected endplates
Syndesmophytes
Increases load stress on facet jonts -> facte joint OA
Decreased size of foramens -> compression of cauda equina/spinal nerve roots
What are syndesmophytes?
Bony growths originating inside a ligament
What causes pain in facet joint OA?
It is innervates by the meningeal branch of the spinal nerve
What are the stages of a slipped intervertebral disc?
Prolapse
Extrusion
Sequestration
What happens in the prolapse stage?
Protrusion of the nucleus pulposus with slight impingement into the spinal cord
What happens in the extrusion stage?
Nucleus pulposus breaks through annulus fibrosus but remains in the disc space
What happens in the sequestration stage?
Nucleus pulposus breaks through the annulus fibrosus and separates form the main body of the disc in the spinal canal
What are the common levels for a prolapsed disc?
L4/5
L5/S1
What are the types of disc prolapse?
Paracentral - most common
Far central
Canal filling
What direction does the disc normally prolapse?
Posterolaterally - causes compression of spinal nerve roots
What is sciatica?
Compression of the nerve roots which contribute to the sciatic nerve - leads to pain/paraesthesia
Which nerve roots contribute to the sciatic nerve?
L4 L5 S1 S2 S3
What are the main types of sciatica?
L4
L5
S1
What is affected by L4 sciatica?
Anterior thigh
Anterior knee
Medial shin
What is affected by L5 sciatica?
Lateral thigh
Lateral calf
Dorsum of foot
What is affected by S1 sciatica?
Posterior thigh
Posterior calf
Heel
Sole of foot
What is cauda equina syndrome?
Compression of the cauda equina
What are the symptoms of cauda equina syndrome?
Bilateral sciatica
Perianal numbness - saddle anaesthesia
Painless urine retention
Urinary/faecal incontinence
What is lumbar canal stenosis?
Narrowing of the lumbar spinal canal
What is claudication?
Pain in legs when walking
Can be
- neurogenic
- vascular
What is spondylolisthesis?
A slip on one vertebrae onto another
