Spinal Pathologies Flashcards Preview

Pathology > Spinal Pathologies > Flashcards

Flashcards in Spinal Pathologies Deck (43):
0

Osteophytes

Extra calcium build up

1

What opens facets?

Flexion, side bend, and rotation

2

Spondylosis

Osteoarthritis of the spine

3

Spondylolysis

A crack, stress fracture, also called pars stress reaction

4

Spondylolisthesis

Vertebral body slips forward off of the vertebra below because the stress fracture worsens

5

Wiltse classification

1. Dysplastic: congenital abnormality
2. Spondylolytic: pars lesion
3. Degenerative
4. Traumatic
5. Pathological

6

Cause of Pars breaks

Repetitive forced lumbar hyper extension
Sudden growth spurt
Increase in training or frequency
Improper technique
Poor posture

7

Meyerdings classification

Grades 1-5

8

Diagnosing Spondy

Painful return from FB
painful extension and rotation and side bend
Step deformity
Referred pain
Shortened stride
Neurological involvement
Imaging tests

9

Treatment of Spondy

Restructured activity to pain free limit of motion
Antilordotic bracing (8-12 weeks)
Minimum of 4-6 weeks conditioning post brace

10

Grade 1 and 2 slippage

Immobilize with torso brace followed by exercise progression

11

Grade 3 and 4 slippage

Bracing if there are limited signs and symptoms
Spinal fusion

12

Spinal stenosis

Narrowing of the lumbar canal

13

Causes of spinal stenosis

Osteophytes
Hypertrophied ligamentum flavum
Hypertrophied facets
Centrally herniated disc
Iatrogenic
Tumor

14

Stenosis diagnosis

Claudicant pain
Relief in flexion, pain in extension
Sensory loss
Extremity weakness
Saddle area numbness

15

Clinical presentation of stenosis

Hyper reflexive DTRs LE
LE weakness
Diffuse dermatomal involvement
Possible balance impairment
+ babinksi

16

Treatment of stenosis

Work on activities to increase mobility an decrease spinal compression:
Stretching
Massage
Increase flexion ROM
positional distraction to open facets

17

Lumbar radiculopathy

Irritation of one or more lumbar nerve roots due to compression (usually L5 and S1)

18

Causes of radiculopathy

Herniated disc
Facet arthritis
Local inflammation
Tumor

19

Causes of disc injury

Poor posture (flat back is the worst)
Obesity
Smoking
Occupation
Improper lifting
Vibration
Repetitive compressive and rotational forces

20

Clinical presentation of radiculopathy

Complaint of LBP
radicular pain
Loss of dermatomal sensation
LE weakness
Intolerance to sitting
Flexion or extension pain patterns

21

Radiculopathy diagnosis

Dermatomal involvement
Myotome weakness
Diminished deep tendon reflexes
Well SLR test
Imaging

22

Lumbar disc herniation classifications

Protrusion
Prolapse
Extrusion
Sequestered

23

Protrusion

Slight out stretching of posterior aspect of annulus and the neurovascular capsule

Instability, ligamentous pain, occasional leg pain

24

Treatment for protrusion

Postural correction
Mckenzie
Stability
Endurance exercises

25

Prolapse

Signs and symptoms similar to protrusion only now leg pain may be more frequent and neurological signs may be presented

26

Treatment for prolapse

Work in decreasing radicular pain first
Posture correction
Stabilization exercises when tolerable
Endurance exercises

27

Extrusion

Outer annulus torn, nucleus starting to escape but staying close to annulus

28

Treatment for extrusion

Acute manage: ice, rest, back brace
For two weeks allow outer annulus to heal

After week 2:
Work on leg pain
Positional distraction
Manuel traction
Mechanical traction
Modalities for pain

29

Sequestered

Nucleus is completely ruptured out

30

Treatment for sequestered

Surgery
Discectomy
Laminar tommy
Fusion

31

Facet syndrome

Pain in one or more facets due to
Trauma causing synovitis
Trauma or awkward movement causing facet entrapment

32

Diagnosis of facet syndrome

Palpate for malalignment
Assess spinal segment mobility
Rule out other spinal pathologies
Determine level and side of problem

33

Treatment for facet syndrome

Ice, estim
Joint manipulation
Postural distraction
Corrective exercises

34

Chronic non specific low back pain

Does not have confirmed spinal pathology

35

Diagnosing CLBP

Present >3 months
Other diagnoses have been ruled out
Segmental instability

36

Treating CLBP

Medical
Cognitive emotional
Physical

37

Back strains

Local muscle injury causing pain with palpation
Limitation in bending

38

Treatment classification groups

Extension syndrome
Flexion syndrome
Mobilization
Traction
Immobilization

39

Stability of the lumbar spine requires

Passive stiffness
Active stiffness

40

Force closure

Using exercise to provide stabilizing closure across the joints

41

Form closure

Being in weight bearing with ligament and bones in tact

42

Impaired diaphragmatic breathing

Disuse of lower abdominal muscles and the resulting lowered resting position of the diaphragm