Spinal Disorders Flashcards
(22 cards)
What is spondylosis?
Degenerative changes of the spine OA.
AKA DJD or DDD
How is the weight of the body distributed through the spine?
2/3 weight through the vertebral body and anterior disc
1/3 weight through the facet joints posteriorly
What age does the disc begin to loose water?
20-40
At what age does the disc increase the rate of water loss and disc space narrowing?
40-60
At what age does the nucleus of the disc become fibrotic rather than gelatinous?
60+
When do you start getting arthritic changes in the facet joints?
40-60 years
When do you start getting subluxation of the facet joints (2ndary to IVF narrowing and decreased disc height)?
60+
What are the three phases of degenerative changes in the spine?
early destruction phase
intermediate instability phase
final stabilization phase
What happens in the early destruction phase of degeneration?
Synovitis of facet joints
Circumferential or radial tears in the annulus of the disc
What happens in the intermediate instability stage of spinal degeneration?
vertebral and peri-facet osteophytes and traction spurs
laxity of posterior capsule and annulus can lead to spondo/retrolisthesis or disc herniation
What happens in the final stabilization phase of spinal degeneration?
Fibrosis of the facets and capsule loss of disc material and height osteophytes Bony ankylosis of verterbal bodies Stenosis
How will someone present with stenosis?
Back pain w/ uni/blateral radicular symptoms
Loss of trunk mobility
Symptoms aggravated with walking, standing upright
Symptoms relieved with sitting, forward flexion or lying down
What is spinal instability and who is it typically seen in?
Loss of integrity of segmental soft tissue structures
Usually seen as degeration in older pts and in younger pts due to trauma, rupture or over stretching of ligaments or due to spondyolisthesis
What is the clinical presentations of instability?
Back or neck pain w/ radicular symptoms
protective muscle spasm
juttering with motion
“step deformity”
What is a Spondylolysis?
Fracture of pars interarticularis
shows up as a scotty dog collar on oblique x-ray
What is a Spondylolisthesis? Where is it most common?
Anterior subluxation of vertebral body. Most common at L4-L5
What are the three types of HNP?
bulge/prolapse-buldge but outer annular fibers remain intact
extruded-nuclear material breaks through annulus but is still connected
sequestered-nuclear material is free mass
What is the most common direction of herniation in the lumbar spine?
Posterolaterally due to thin posterior longitudional ligament
What are the demographics you see most often herniated NP’s?
Ages 31-50
somewhat more common in men
repetitive lifting, forward bending, driving, twistin
Are you more or less likely to have symptoms below the knee with lumbar disc dysfunction?
More likely to have symptoms below the knee
How will the lumbar spine usually present with a lumbar disc dysfunction?
forward flexed or flattened lumbar spine or lateral shift
What is the order of positional tolerance with a lumbar disc dysfunction?
Lying>walking>standing>sitting most to least comfortable position
