What does muscle strain mean?
General Ache or muscl spasm radiating to buttoch/post. thighs worsening with increasing activity/bending
Whar are the most common spine pathologies associated to obesity?
Lumbar disc degeneration leading to LBP
Sciatica syndrome
Lumbar spinal stenosis
What is the pathophysiology of spinal stenosis?
Dehydration/degeneration intervertebral discs
Posterior disc height loss
Retrolistehesis/pseudolisthesis
Facet joint subluxation
Osteoarthritic joints/enlarged
Deformity
Which mm ranges are considered cervical and lumbar spinal stenosis?
Cervical diameter < 14 mm
Lumbar < 10 mm = absolute
Lumbar < 12 mm = relative
What are the clinical features of lumbar spinal stenosis?
Radiculopathy
Pain worsened with extension/standing
Improved with flexion/sitting
Motor/sensory changes
What are the most common lumbar spine levels associated with lumbar stenosis in obese patients?
L4/5 (92%)
L3/4 (65%)
L2/3 (30%)
L5/S1 (28%)
How is lumbar stenosis classified according to the location?
Central
Lateral recess stenosis
Foraminal stenosis
Extraforaminal stenosis
What is the most common cause of central lumbar stenosis?
Broad-based disc-osteophyte complex / ligamentum flavum hypertrophy
What are factors for foraminal lumbar stenosis?
Loss of disc height
Foraminal disc protrusions
Osteophytes
Degenerative scoliosis
What are factors for lateral lumbar stenosis?
Facet hypertrophy
What is the main cause for extraforaminal lumbar stenosis?
Lateral disc herniation
What is the most prevalent symptom in lumbar spinal stenosis?
Neurogenic claudication (numbness, weakness, discomfort in legs while prolonged standind, improving with forward bending)
Radicular claudication is produced by foraminal/lateral recess stenosis
What are risk factors for lumbar spinal stenosis?
Age > 65
Male
BMI > 29.5
Caucasian people
What are the medical treatment options for lumbar stenosis?
Medications (NSAIDS, Muscle relaxants)
Physiotherapy
Corticosteriod injections
What is the Ranawat classification of rheumatoid myelopahty?
It evaluates the success of surgical treatment in rheumatoid myelopathy
Describe the Nurick Grading System.
It evaluated disability in cervical spondylotic myelopathy.
What are the major mechanisms of spinal cord injuries in geriatric patients?
Falls (74%)
Motor vehicle accidents (13%)
What is the most common cause of lumbar spine surgery in geriatric patients?
What are the major complications for spine surgery in obese patients?
Infections
Reoperation
Less improvement form basal physical function
What is the modified Pfirrmann Grading system?
Grading system for lumbar degenerative disc changes on sagittal T2 MRI
What is spondylosis?
Degenerative disc disease
Non-inflammatory disc and motion of vertebral body yield vertabral osteophytosis that will irritate the nerve root
What is the clinic of cervical spondylosis?
Chronic/episodic neck and radicular arm pain
Includes multiple levels of unilateral paresthesias/paresis
Myotomal atrophy/fasciculations
Last changed2 years ago