1.7 Lumbar Discogenic Pain Overview

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Questions and Answers

Which type of vertebral endplate lesion is often found with bone marrow edema in imaging studies?

  • Fracture in the center of the endplate (correct)
  • Schmorl node
  • Erosion in the rim of the endplate
  • Calcification in the center and rim portion of the endplate

What type of pain can result from increased interosseous pressure due to vertebral endplate lesions?

  • Muscle pain
  • Nerve ablation pain
  • Discogenic pain (correct)
  • Facet joint pain

Which of the following systemic bone diseases may be associated with disc and end plate lesions?

  • Osteoporosis
  • 'Paget disease'
  • Bone tumor and infection
  • All of the above (correct)

What is a common non-pharmacological management approach for discogenic pain?

<p>A structured exercise program (A)</p> Signup and view all the answers

Which therapy involves using electrophysical agents like hot packs, TENS, and ultrasound for managing discogenic pain?

<p>Combination of electrophysical agents (D)</p> Signup and view all the answers

Which of the following is a surgical management option for discogenic pain?

<p>Intradiscal radiofrequency electrothermal therapies (B)</p> Signup and view all the answers

What are the common types of tears that the annulus fibrosus is prone to develop?

<p>Transverse, circumferential, and radial tears (B)</p> Signup and view all the answers

Which area of the disc is more prone to tears in a posterior or posterolateral direction?

<p>Outer layers (A)</p> Signup and view all the answers

Why is the healing response of the inner portion of the intervertebral disc limited?

<p>Because it relies on diffusion for nutritional supply (C)</p> Signup and view all the answers

Which type of disc bulge/herniation is clinically more significant due to neural tissue compression?

<p>Posterior disc bulge/herniation (C)</p> Signup and view all the answers

What is the term for horizontal splits and clefts common at the junction of the nucleus pulposus and annulus fibrosus?

<p>Transitional zone tears (B)</p> Signup and view all the answers

Why are repetitive stress, overuse, wear and tear, and age-related degeneration more common in intervertebral disc structures?

<p>As a result of limited healing responses to strains or sprains (C)</p> Signup and view all the answers

What are the potential symptoms associated with lumbar spine disc bulge and herniation?

<p>Localized axial back pain, referred pain to the lumbopelvic region, and radicular pain along the nerve course (B)</p> Signup and view all the answers

What is a common symptom associated with discogenic pain?

<p>Pins and needles, paresthesia, and numbness (B)</p> Signup and view all the answers

Why is it important to consider endplate lesions as a source of back pain?

<p>Their relationship with disc lesions and pain symptoms is well established (C)</p> Signup and view all the answers

Which type of lesion involves protrusion of disc tissues into the vertebral marrow through the endplate?

<p>Schmorl’s node (C)</p> Signup and view all the answers

What is one common type of Modic lesion associated with the vertebral end plate?

<p>Peripheral rim calcification/sclerosis (A)</p> Signup and view all the answers

Which age group is commonly affected by vertebral endplate lesions?

<p>Middle-aged men (A)</p> Signup and view all the answers

'Neural claudication' is caused by compression of which structure?

<p>Nerve root (C)</p> Signup and view all the answers

'Modic lesion' is associated with direct lesions of which anatomical structures?

<p>'Vertebral end plate' and 'adjacent trabecular bone' (D)</p> Signup and view all the answers

'Schmorl’s node' can be categorized based on which characteristic?

<p>'Shape' (D)</p> Signup and view all the answers

'Spontaneous and/or sudden onset of severe back pain' along with 'bladder and bowel incontinence' may indicate:

<p>'Major neurological complications' (B)</p> Signup and view all the answers

What is the main difference between disc bulge and disc herniation?

<p>Disc bulge involves diffuse annular expansion, while disc herniation involves a localized displacement of disc materials. (A)</p> Signup and view all the answers

Why is annulus fibres tear considered a source of back pain?

<p>It leads to mechanical deformation of the disc tissue. (C)</p> Signup and view all the answers

How does edema from inflammation affect disc pressure?

<p>It increases disc pressure. (D)</p> Signup and view all the answers

What is the impact of depressurization of the nucleus and posterior annulus?

<p>It reduces pain. (D)</p> Signup and view all the answers

How do both disc bulge and herniation affect segmental stiffness and instability?

<p>They reduce segmental stiffness and increase instability. (B)</p> Signup and view all the answers

What is the main implication of moderate-level degenerative changes in the nucleus and annulus?

<p>Reduced spinal stability and increased neutral zone of intervertebral joint play. (D)</p> Signup and view all the answers

How do disc bulge and herniation impact the posture and balance of spinal segments?

<p>They alter the posture and balance of spinal segments. (D)</p> Signup and view all the answers

What are the common risks associated with disc bulges in young people?

<p>Increased fibrous material in the discs, resulting in less flexibility (C)</p> Signup and view all the answers

What is the implication of severe-stage disc degeneration on intervertebral joints?

<p>Reduced mobility or stiffness (C)</p> Signup and view all the answers

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