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Flashcards in Management of spinal issues Deck (31):
1

Back pain is what number reason for clinic visits?

2

2

What are the three initial concerns with LBP?

1. Systemic disease
2. Neurologic compromise
3. Social/psychological stress

3

Duration of pain greater than what amount of time is a red flag?

more than one month

4

Over what age is a red flag?

50 years

5

What percent of LBP may be due to SDs?

70%

6

What are the landmarks of the OSE?

Shoulder heights
Crest heights
Greater trochanter heights
Standing and seated flexion

7

True or false: most patients with LBP without other symptoms usually improve rapidly

True

8

Is imaging indicated for nonspecific LBP

No

9

What are the four types of red flag conditions that warrant imaging?

Fracture
Infection
Neoplasms
Severe neurologic deficit

(FINS)

10

When should plain x-rays be obtained for LBP?

not improved for 4-6 weeks

11

When is MRI indicated for back pain?

If persists longer than 12 weeks

12

Why are labs good for evaluation of back pain?

Systemic disease evaluation

13

True or false: manipulation treatment is as effective as conventional medical therapy

True

14

What is the biomechanical perspective of LBP?

Address SDs to allow MS to operate more efficiently

15

What are the main benefits of OMT?

Reduced time and money on surgery and other treatments

16

How many treatments are considered a trial of OMT?

3-4

17

Is bed rest indicated for LBP?

Nope

18

What are interventional treatments for LBP? Is this diagnostic or therapeutic?

fluoroscope guided injection
Both diagnostic and therapeutic

19

What are the specialist for LBP?

Physiatrist/neurologist

20

What are the three things that a physician spine specialist looks for?

Disc disease
Facet disease
Referred pain

21

When should surgery be considered? (3)

-Spinal neurological pathology
-Spinal instability
-Conservative treatments fail

22

What are the two types of spine surgeons?

Neurosurgeons
Ortho

23

What are the three diseases that need a surgical consult?

1. Cauda equina
2. Suspected spinal cor dcompression
3. Progressive neuro deficit

24

Who would you refer a radiculopathy to: a neurosurgeon, or ortho?

Either

25

Who would you refer a myelopathy to: a neurosurgeon, or ortho?

Neuro

26

Who would you refer a spinal instability to: a neurosurgeon, or ortho?

Ortho

27

What are the three reasons for treating OMT with LBP?

Effective
Decreases med needs
Decrease needs for other treatments

28

What are the areas of the body that should be assessed with an osteopathic structural exam for LBP? (6)

-Innominates
-Sacrum
-Pubic symphysis
-Lumbar spine segments
-Fascial patterns at transitional areas
-Major muscles related to the low back

29

What are the two general rules for ordering imaging for LBP?

-Severe progressive neuro deficits
-Ssx that suggest underlying condition

30

What are the general components of conservative treatment of LBP?

Activity modification
OMT
Injections

31

Neuromotor deficits that do not improve with conservative therapy in what timeframe should be referred to a neurologist?

4-6 weeks of conservative therapy