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Flashcards in Lumbar Spine II Deck (36)
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1

Classification of spinal stenosis

1. central spinal canal
2. intervertebral foreman
3. subarticular or lateral recesses

2

What portion of the population may have asymptomatic spinal stenosis under the age of 40?

1/4

3

When does spinal stenosis first appear and who is it most likely to affect?

40-50 years old
men

4

What region is spinal stenosis most common in?

cervical and lumbar spinal regions

5

Where is central canal narrowing most prevalent

L4

6

Normal AP diameter of spinal canal adult men C3-C5:

17-18mm

7

Normal AP diameter of spinal canal adult men C5-C7:

12-14mm

8

Normal AP diameter of spinal canal adult men thoracic spine:

12-14 mm

9

Normal AP diameter of spinal canal adult men lumbar spine

15-27mm

10

What is the most serious complication of c-spine spinal stenosis?

central cord syndrome

11

What kind of injury is central cord syndrome associated with?

hyperextension

12

What is cervical spinal stenosis associated with?

Long tract and radicular signs
Headaches
Pain
Radiating electric-like shock sensations elicited with cervical spine flexion

13

What can concurrent cervical and lumbar spinal stenosis can present with?

Gait disturbance
Myelopathy
Radiculopathy

14

What does lumbar spine stenosis present with?

Diffuse unilateral or bilateral LBP and/or LE pain
Numbness
Weakness

15

What does lumbar extension do?

narrows canals and exacerbates symptoms

16

What does lumbar flexion do?

opens available space and provides some relief

17

Simian stance:

trunk, hip, and knee flexion

18

What is neurogenic claudication?

congestion of blood vessels at stenotic level

19

What does neurogenic claudication inhibit?

nerve conduction and results in poorly defined leg pain, numbness, and weakness

20

What exacerbates neurogenic claudication?

standing and spinal extension

21

What exacerbates vascular claudication?

exercise and improved with standing

22

What aggravates disk herniation?

sitting, flexion, lifting, and Valsalva maneuvers and often relieved with walking

23

What imaging technique is widely used for evaluation of spinal stenosis?

CT

24

How is mild and moderate spinal stenosis managed?

Analgesic medications
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Epidural steroid injections
PT for strengthening and flexibility exercises

25

What is an intervertebral disk herniation (IVDH)?

extension of NP through AF and beyond adjacent vertebral margins

26

Who is IVDH most common among?

25-45
men
smoke or obese or exposed to vehicular vibration

27

Where is IVDH most common?

lumbar spine
L4-L5

28

Where is cervical spine IDVH most common?

C5-C6
radiculopathy

29

What symptoms do intraspinal disk herniations cause?

LBP and referred or radicular pain

30

Intraspinal disk herniation symptoms are exacerbated how?

active flexion, prolonged sitting, and Valsalva maneuvers