Lumbar Spine Flashcards
(49 cards)
What is radiculopathy?
A non-specific diagnosis characterized by nerve root ‘irritation’ and pain radiating down the extremity.
At what age does the peak incidence of herniated nucleus pulposus occur? What gender is more likely to develop it?
30-50 years old, males 2:1
True or False: Herniated nucleus pulposus primarily occurs in the cervical spine.
False
What is the most common site for herniated nucleus pulposus?
L4-L5 and L5-S1
What are the common symptoms of a lumbar strain?
- Deep, steady pain in the low back
- Pain with activity, relieved by rest
- Stiffness
- Muscular tenderness
- may radiate to buttock or posterior thigh
What is the significance of the Babinski reflex in a neurological exam?
Indicates central pathology (brain + spinal cord) if the great toe extends with flexion of other toes in individuals greater than two years old.
Fill in the blank: The standard diagnostic modality of choice for herniated nucleus pulposus is _______.
MRI
What is ankylosing spondylitis?
An autoimmune spondyloarthropathy characterized by inflammation of the spine and associated structures.
What is the typical demographic for ankylosing spondylitis?
Caucasian males around age 30
What does a positive Schober’s test indicate?
Decreased spine range of motion in ankylosing spondylitis.
What is spondylolysis?
A fracture in the pars interarticularis, often asymptomatic but can lead to low back pain.
What is the typical risk factor for developing spondylolysis?
Repetitive hyperextension activities, such as gymnastics or pole vaulting.
What imaging findings are associated with degenerative disc disease?
- Loss of disc height
*loss of disc hydration - Osteophyte formation
- facet joint arthritis
*ligamentous/joint hypertrophy
What is the hallmark of lumbar spinal stenosis?
Neurogenic claudication, characterized by pain/weakness in the lower extremities precipitated by walking and relieved by rest.
What is the first-line imaging for diagnosing spinal stenosis?
MRI
What are the common treatment options for lumbar spine disorders?
- Heat and/or ice
- Physical therapy
- Medications
- Surgery
What is the condition characterized by anterior or posterior translation of a vertebra?
Spondylolisthesis
Fill in the blank: The presence of bilateral sacroiliitis with positive HLA-B27 and uveitis helps to confirm the diagnosis of _______.
Ankylosing Spondylitis
What are the common associated systemic symptoms of ankylosing spondylitis?
- Uveitis
- Heart disease
- Pulmonary fibrosis
- Renal amyloidosis
- aortic abnormalities
What is the typical age-related prevalence of degenerative disc disease in individuals over 60 years old?
90%
What type of pain is usually described in cauda equina syndrome?
Shooting or stabbing pain
Pain radiates down the affected lower extremity (LE) past the knee and may have associated neurologic symptoms such as weakness and numbness.
What is a common characteristic of patients with cauda equina syndrome?
*Bowel or bladder dysfunction
*unilateral or bilateral lower extremity pains
*saddle anesthesia
*decreased anal sphincter tone
What physical exam finding increases pain in cauda equina syndrome?
Pain increased with coughing, sneezing, or Valsalva maneuver
A positive straight leg raise may also be noted.
What is the most common cause of cauda equina syndrome?
Large disc herniations
L4-L5 is the most commonly affected level, occurring in 1-6% of lumbar herniated discs.
