1.7 Lumbar Discogenic Pain Overview

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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?

A structured exercise program Signup and view all the answers

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

Combination of electrophysical agents Signup and view all the answers

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

Intradiscal radiofrequency electrothermal therapies Signup and view all the answers

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

Transverse, circumferential, and radial tears Signup and view all the answers

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

Outer layers Signup and view all the answers

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

Because it relies on diffusion for nutritional supply Signup and view all the answers

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

Posterior disc bulge/herniation 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?

Transitional zone tears Signup and view all the answers

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

As a result of limited healing responses to strains or sprains Signup and view all the answers

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

Localized axial back pain, referred pain to the lumbopelvic region, and radicular pain along the nerve course Signup and view all the answers

What is a common symptom associated with discogenic pain?

Pins and needles, paresthesia, and numbness Signup and view all the answers

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

Their relationship with disc lesions and pain symptoms is well established Signup and view all the answers

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

Schmorl’s node Signup and view all the answers

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

Peripheral rim calcification/sclerosis Signup and view all the answers

Which age group is commonly affected by vertebral endplate lesions?

Middle-aged men Signup and view all the answers

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

Nerve root Signup and view all the answers

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

'Vertebral end plate' and 'adjacent trabecular bone' Signup and view all the answers

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

'Shape' Signup and view all the answers

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

'Major neurological complications' Signup and view all the answers

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

Disc bulge involves diffuse annular expansion, while disc herniation involves a localized displacement of disc materials. Signup and view all the answers

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

It leads to mechanical deformation of the disc tissue. Signup and view all the answers

How does edema from inflammation affect disc pressure?

It increases disc pressure. Signup and view all the answers

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

It reduces pain. Signup and view all the answers

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

They reduce segmental stiffness and increase instability. Signup and view all the answers

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

Reduced spinal stability and increased neutral zone of intervertebral joint play. Signup and view all the answers

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

They alter the posture and balance of spinal segments. Signup and view all the answers

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

Increased fibrous material in the discs, resulting in less flexibility Signup and view all the answers

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

Reduced mobility or stiffness Signup and view all the answers