Spinal Conditions Flashcards
(28 cards)
Ankylosing Spondilitis
An inflammatory arthritis of the entire body. It is characteristed as a disregulation of the immune system, giving arise to immune cells which attack auto antigens, resulting in inappropriate inflammation and leading to potential tissue damage.
It tends to affect where ligaments attach bone to bone and is classed as a progressive condition due to harm to the tissue damage.
Risk factors:
Men
Genetics
HLA B gene
Late adolescence
Treatment for Ankylosing Spondylitis
Medications
Physiotherapy to facilitate movement/ patient comfort
INF therapy and IL 17A inhibitors
Combination of pharmacological management and exercise
Exercise needs to be low impact like walking or cycling.
Programme called “back to action” to encourage patients back to the gym for a gradual rehab.
Symptoms of Ankylosing spondylitis
Early morning stiffness
Weight loss
Fatigue
Muscle weakness and soreness
Spondylilosthesis
A condition where there is an anterior displacement of a superior vertebrae on an inferior vertebrae. Tends to occur in the lumbar spine, usually affecting (L4/L5) and (L5-S1).
Risk factors of Spondylolisthesis
Genetics
Trauma
Natural degeneration
Management for Spondylolisthesis
Physiotherapy to restore movement and mobility
Surgery in order to realign the spine using metal rods and plates
Spinal stenosis
A narrowing of the central canal in the spinal vertebrae, potentially causing compressions on the spinal cord. In the cervical spine this could be a Myelopathy and in the lumbar spine this could be a medical emergency, Cauda Equina syndrome. Can give corresponding nerve pain to the area which the affected nerve supply.
Risk factors of spinal stenosis
Osteoporosis resulting in bone degeneration and bone fragments being wedged into the spinal cord.
Disc herniation
Thickened ligaments
Bony spurs from the vertebrae
Management for spinal stenosis
Might require surgical management in order to remove whatever is blocking the spine. Disectomy relating to disc herniation and decompression relating to other factors blocking the spinal cord like bone fragments or thickened ligaments.
Physiotherapy to help restore comfort movement and ROM.
Pain management
Lifestyle changes
Spondylosis
An osteoarthritic condition of the vertebrae in the cervical, thoracic or lumbar spine.
Usually affects joints of the spine, like Hubert Von Lushka, intervertebral discs, facet joints, lamina.
Can then lead to a spinal stenosis if it begins to block the spinal cord in the central canal.
Risk factors of Spondylosis
Usual normal age related changes that can’t be prevented. Referenced to natural wrinkles from aging.
Management for Spondylosis
Surgical management to remove osteoarthritic areas from the spinal cord.
Pain management
Lifestyle changes
Reassurance
Encourage range of movement
Scoliosis
Characterised as an S shape curve in the spine
Risk factors of Scoliosis
No specific risks, it is genetically determined.
Idiopathic
It doesn’t necessarily get worse over time. Can live with scoliosis for life and not have any issues, however some cases may require surgical management.
Symptoms can include muscle pain and soreness due to the muscles compensating for the side of the body which is put under more stress due to less support from the spine.
Management for scoliosis
Surgical intervention. This requires re aligning the spine so it is straight and continue with normal function. They will use metal rods and plates to hold the spine in place. Occurs if the COBB angle is more than 50 degrees.
Physiotherapy to help adapt to normal life and restore ROM and stability in the spine.
Whiplash
Characterised as a term for neck pain as a result of an acceleration/decelleration/ acceleration sudden force movement. Most likely causes are RTA.
Keep an eye out for insurance claims when treating patients
Whiplash symptoms
Dizziness
Unconsciousness
Malaise and fatigue
Confusion
Blurred vision
Neck pain/ upper back pain
Whiplash management
Education and reassurance to patient that the symptoms are not long lasting and will eventually subside.
Pain relief short term
Non specific spinal pain and sciatica
Use non pharmacological methods like self management techniques, physiotherapy, education and advice
Myelopathy
Occurs in the cervical spine and is a result of a spinal compression. This can be due to disc herniations, bony spurs and thickened ligaments surrounding the central canal, Spondylolisthesis
Symptoms of myelopathy
Gait disturbances
Fine motor skill and sensory skills affected
Neck pain and nerve pain
Risk factors for myelopathy
Trauma
Age degeneration
Disorders like Ankylosing spondylitis, rheumatoid arthritis.
Management for myelopathy
Conservative management like physiotherapy.
Surgical intervention to re aligning the spine
Cauda Equina syndrome
It is a compression of the bundle of nerve fibres which consist of L2-S5 and coccygeal nerve roots. Most common cause is herniation of the lumbar disc (45%) causing compression on the nerve roots. Spinal stenosis, Spondylolisthesis could also be causes.
