Spondylolisthesis, Spondylolysis and Back Pain
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Questions and Answers

Which of the following is a potential cause of spondylolisthesis?

  • Vitamin deficiency
  • Congenital condition (correct)
  • Poor posture
  • Infection

What diagnostic tool is typically used to identify spondylolisthesis?

  • X-ray (correct)
  • Ultrasound
  • Blood test
  • MRI

What is the defining characteristic of spondylolysis?

  • Disc herniation
  • Fracture of the pars interarticularis (correct)
  • Spinal stenosis
  • Vertebral displacement

According to the Meyerding scale, what percentage of vertebral displacement is classified as Grade 2 spondylolisthesis?

<p>25-50% (D)</p> Signup and view all the answers

Which activity is most associated with spondylolysis?

<p>Excessive end-range extension (A)</p> Signup and view all the answers

What is a common characteristic of Schmorl's nodes?

<p>Disc herniation through the vertebral endplate (C)</p> Signup and view all the answers

Which of the following is a sign or symptom commonly associated with facet joint problems?

<p>Pain relieved by movement (C)</p> Signup and view all the answers

What radiographic finding is associated with spondylolysis diagnosis?

<p>Scotty Dog collar sign (D)</p> Signup and view all the answers

What is the primary focus of conservative treatment for spondylolysis?

<p>Flexion bias (D)</p> Signup and view all the answers

What condition involves the anterior displacement of a vertebral body due to a pars fracture?

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

Which of the following is an impairment-based classification for low back pain?

<p>Low back pain with mobility deficits (A)</p> Signup and view all the answers

What is the primary characteristic of Ankylosing Spondylitis?

<p>Inflammation leading to potential spinal fusion (B)</p> Signup and view all the answers

Which imaging technique is typically used to diagnose a compression fracture?

<p>X-ray (B)</p> Signup and view all the answers

Which of the following is a common symptom of a compression fracture?

<p>Pain at the site of fracture (A)</p> Signup and view all the answers

Which of the following is a treatment option for compression fractures?

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

Which of the following is considered a 'red flag' symptom that may indicate a serious spinal pathology?

<p>Night pain (D)</p> Signup and view all the answers

Which of the following is a common source of secondary tumors in the spine?

<p>Breast (B)</p> Signup and view all the answers

Which of the following is a risk factor for compression fractures?

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

Which type of disc herniation involves the nuclear material escaping but remaining in one piece?

<p>Extrusion (B)</p> Signup and view all the answers

In which type of disc herniation does the nuclear material separate and become free from the disc?

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

Which of these is a non-surgical treatment option for disc herniation?

<p>Direction-specific exercises (C)</p> Signup and view all the answers

During disc degeneration, what is happening to the inner rings of the disc?

<p>They are breaking down (D)</p> Signup and view all the answers

Which of the following is a common symptom associated with disc herniation?

<p>Radiating pain (D)</p> Signup and view all the answers

Which of the following is a conservative treatment for facet arthritis?

<p>Manual therapy (A)</p> Signup and view all the answers

SI joint dysfunction is commonly associated with which condition?

<p>Hypermobility (B)</p> Signup and view all the answers

Which of the following activities might aggravate SI joint pain?

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

What is a common symptom associated with SI joint dysfunction?

<p>Localized and/or generalized pain (D)</p> Signup and view all the answers

Which of the following is a potential treatment for SI joint dysfunction?

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

What happens to the intervertebral disc height in Degenerative Disc Disease (DDD)?

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

What is a primary factor contributing to the degeneration of intervertebral discs?

<p>Decrease in proteoglycans (D)</p> Signup and view all the answers

What percentage of asymptomatic people between 60 and 80 years old have disc bulge?

<p>69-84% (A)</p> Signup and view all the answers

What is a common age-related risk factor for radiculopathy in men?

<p>40s (B)</p> Signup and view all the answers

Which of the following is a potential cause of radiculopathy?

<p>Disc herniation (D)</p> Signup and view all the answers

Which of the following is a typical symptom associated with central stenosis?

<p>Bilateral leg symptoms (A)</p> Signup and view all the answers

What is a characteristic of central stenosis regarding the spinal canal?

<p>Narrowing of spinal cord space (A)</p> Signup and view all the answers

Which of the following is a potential cause of foraminal stenosis?

<p>Disc pathology (D)</p> Signup and view all the answers

What type of symptoms are commonly associated with foraminal stenosis?

<p>Unilateral symptoms (C)</p> Signup and view all the answers

What is a potential outcome of nerve entrapment?

<p>Increased nerve sensitivity (B)</p> Signup and view all the answers

Which of the following is associated with nerve entrapment in the spine?

<p>The connective tissues shorten (B)</p> Signup and view all the answers

Flashcards

Lumbopelvic Pathology

Conditions affecting the lower back and pelvis regions, influencing movement and stability.

Pathology

Structural and functional changes in tissues indicating disease or injury.

Impairment-based classification

System to categorize low back pain based on movement capabilities, not just pathology.

Ankylosing Spondylitis

Inflammatory spinal disease leading to fusion, mainly in young men.

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Compression Fracture

A type of fracture commonly occurring in the spine, often due to osteoporosis or trauma.

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Red Flags (in Tumors)

Warnings indicating serious conditions, such as unexplained weight loss or persistent pain.

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Primary Tumors

Tumors originating in the spine, like osteosarcoma; rare but serious.

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Secondary Tumors

Tumors that spread to the spine from other body parts such as breast or lung.

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Spondylolysis

Fracture of pars interarticularis without vertebral displacement, often caused by repetitive extension.

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Symptoms of Spondylolysis

Pain localized to the low back, can be acute or chronic.

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Diagnosis for Spondylolysis

Identified through X-ray; look for Scotty Dog collar sign.

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Spondylolisthesis

Pars fracture with anterior displacement of the vertebral body, more common in the lumbar region.

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Treatment for Spondylolysis

Typically conservative, involving flexion bias, bracing, and time for healing.

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Meyerding Scale

A grading system for spondylolisthesis based on slippage percentage.

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Spondyloptosis

A severe form of spondylolisthesis with over 100% slippage.

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Schmorl’s Nodes

Disc herniation into the vertebral body, often asymptomatic.

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Facet Joint Pathology

Degenerative changes in facet joints, leading to pain and stiffness.

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Disc Herniation

A condition where spinal disc material bulges or leaks out, causing pain.

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Posterolateral Herniation

The most common type of disc herniation, occurring at the back and side of the disc.

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Extrusion

When nuclear material escapes the disc but remains in one piece, sometimes involving the annulus.

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Sequestration

A condition where nuclear material breaks free from the disc entirely, potentially causing more symptoms.

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Conservative Treatment

Non-surgical approaches for disc herniation, including time and specific exercises.

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SI Joint Pain

Pain often related to hypermobility, present in peripartum women and those with connective tissue disorders.

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Disc Herniation Prevalence

Pain related to disc herniation affects 1.6-13.4% of individuals, particularly older adults.

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Degenerative Disc Disease (DDD)

Condition where intervertebral discs degenerate, affecting height and leading to increased joint load.

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Signs of SI Joint Dysfunction

Signs include stiff, sharp, or tingling symptoms, often with pain during sitting or standing.

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Treatment for SI Joint Pain

Treatment includes conservative options like bracing, manual therapy, and strengthening exercises.

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Symptoms of Disc Pathology

Symptoms can include localized pain, often exacerbated by certain movements or inactivity.

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Growth of Disc Bulges

69-84% of asymptomatic older adults have disc bulges, even without pain.

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Risk Factors for DDD

Genetic links and possible lifestyle factors contribute to the likelihood of developing degenerative disc disease.

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Radiculopathy

A condition characterized by pain and neurological deficits due to nerve root compression.

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Central Stenosis

Narrowing of the spinal canal space, potentially affecting the spinal cord.

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Foraminal Stenosis

Narrowing of the foramen where nerves exit the spine, often causing pain.

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Nerve Entrapment

Condition where nerves are compressed or tethered, leading to pain and paresthesia.

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True neurological deficits

Neurological signs caused by issues with nerve roots, affecting reflexes and muscle strength.

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Neurogenic Claudication

Pain, cramping, or heaviness in the legs caused by spinal nerve issues, especially when walking.

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Lower Motor Neuron deficits

Weakness or loss of function resulting from issues with lower motor neurons at nerve roots.

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Upper Motor Neuron deficits

Neurological signs like spasticity or exaggerated reflexes due to central nervous system issues.

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Study Notes

Lumbopelvic Pathology Overview

  • The presentation covers various pathologies affecting the lumbar and pelvic regions.
  • Objectives include understanding impairment-based classification of low back pain and common lumbopelvic pathologies.
  • Pathology is defined as structural and/or functional deviations from normal that characterize a disease and study of changes produced.
  • Pathology doesn't always correlate with pain or limitation.

Serious/Systemic Pathology

  • Includes conditions like spondyloarthropathies (ankylosing spondylitis), cauda equina syndrome, abdominal aortic aneurysm (AAA), cancer, and fractures.

Ankylosing Spondylitis

  • An inflammatory condition of the spine, eventually leading to fusion.
  • Primarily affects men in early adulthood (80% under 40).
  • Incidence ranges from 0.2% to 0.5%.
  • Symptoms include SI joint and lumbar pain, pain worsened by inactivity, and improved with movement. Associated conditions include uveitis and hip/shoulder joint pain. Achilles enthesitis is another symptom.
  • Diagnosis involves X-ray (sacroiliitis) and blood tests (HLA-B27).
  • Treatment includes anti-inflammatory medication and exercise for mobility and strengthening.

Cauda Equina Syndrome

  • Compression of the cauda equina (bundle of nerves) due to trauma, disc protrusion, hemorrhage, tumor, etc.
  • Incidence is low (0.005% to 0.03% of back pain).
  • Symptoms include urinary retention/incontinence, "saddle anesthesia" (sensory changes), and loss of anal sphincter tone (fecal incontinence).
  • Medical emergency requiring rapid decompression to avoid permanent damage.

Abdominal Aortic Aneurysm (AAA)

  • Dilation of abdominal aorta exceeding 3 cm (1.2 inches).
  • Affects older men more frequently (4-8%) than older women (0.5-1.5%).
  • Symptoms include abdominal pain and backache.
  • Risk factors include age, smoking, and family history.
  • Diagnostics include palpation and imaging (ultrasound, CT, MRI).

Compression Fracture

  • Most frequent in vertebrae T8, T12, L1, and L5.
  • More common in young, due to trauma and more common in older people, due to minor injuries.
  • Risk factors include post-menopausal women, osteoporosis, and long-term corticosteroid use.
  • Symptoms include pain at fracture site, limited motion, and may require kyphoplasty and/or fusion.
  • X-ray is used for diagnosis.

Tumors (Spine Tumors)

  • Primary tumors are rare, originating in the spine (e.g., osteosarcoma, multiple myeloma).
  • Secondary tumors are more common; metastases from other areas (e.g., breast, lung, thyroid, kidney, prostate).
  • Red flags include unexplained weight loss, pain not relieved by rest, and nocturnal pain.
  • Imaging (X-ray, MRI) is used to diagnose tumors.

Bone Pathologies

  • Spondylolysis: Fracture of pars interarticularis without vertebral displacement.
  • Spondylolisthesis: Pars fracture with anterior vertebral body displacement.
  • Meyerding scale grades spondylolisthesis based on percentage displacement.
  • Schmorls nodes are disc herniation into vertebral body. Usually asymptomatic.

Joint Pathology

  • Spondylosis, degenerative joint disease (DJD), osteoarthritis (OA), and facet arthropathy are different terms for similar conditions.
  • Contributing factors include genetics, lifestyle, and trauma.
  • Arthritic changes include osteophytes (bone spurs), cartilage loss, and capsule thickening.

Facet Joint

  • Pain/stiffness often relieved by movement, local, and referred.
  • "Closed" positions (standing, walking) often exacerbate discomfort.
  • Treatment often involves conservative approaches such as physical therapy (mobility, manual therapy), injections, or radiofrequency ablation.

SI Joint

  • Often associated with hypermobility, common in peripartum women and hypermobile people.
  • Symptoms include low back pain with movement coordination impairments, stiff, sharp, or tingling localized & generalized pain, sitting/inactivity, & weight shifting to affected side.
  • Treatment includes conservative methods (bracing, manual therapy), strengthening exercises, injections, and potentially surgery.

Disc Pathology

  • Disc herniation is a prevalent concern and its prevalence is influenced by age, ranging from 1.6% to 13.4%.
  • Prevalence is significantly impacted by age, with a noticeable increase after age 20.
  • Degenerative disc disease and disc herniation often co-occur, with the latter showing a high prevalence of asymptomatic abnormalities, especially in those between 60 and 80.

Nerve Pathology

  • Includes radiculopathy (nerve root compression, symptoms include neurological deficits, pain in associated area).
  • Stenosis (narrowing of spinal canal).
  • Entrapment (nerve compression) - and "Double Crush" syndrome(multiple nerve compressions).
  • Treatment includes conservative methods (mobility/time limitations), injections, or surgery.

Contractile Pathology

  • Muscle strains, acute/chronic overuse (myofascial pain), muscle spasms (protective mechanism), can originate due to injury to contractile tissue, joints, discs, or nerves
  • Symptoms include soreness/stiffness, aching/sharp localized pain in lumbar musculature, limited range of motion.
  • Treatment often involves conservative care (time), stretching, and trigger point injections.

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Lumbopelvic Pathology PDF

Description

Test your knowledge of spondylolisthesis, spondylolysis, and related back pain conditions. The quiz covers causes, diagnosis, symptoms, and treatment options for these spinal disorders. Questions address spondylolysis, vertebral displacement, facet joint problems, and Ankylosing Spondylitis.

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