Department of Neurology. Utara, School of Medicine
|
|
- Emily Stephens
- 5 years ago
- Views:
Transcription
1 LOW BACK PAIN Aldy S. Rambe Department of Neurology University of Sumatera Utara, School of Medicine
2 What is LBP Low back pain is a common disorder affecting millions of individuals annually. Back pain is the single most common cause for lost workdays in the United States and one of the most common reasons for patients to visit their primary care physician. It is estimated that approximately 50 to 80% of the adult population suffers from a memorable episode of low back pain each year. In the vast majority of cases no specific diagnosis is made and the symptoms resolve spontaneously. Only a minority of patients present with symptoms specific to an irritated nerve root or have identifiable pathology on radiographic studies. The overall prognosis of low back pain is good, with improvement occurring in the majority of cases without aggressive medical intervention.
3 ANATOMY
4 ANATOMY
5 CLASSIFICATION ACCORDING TO ITS DURATION, LBP IS DIVIDED INTO : ACUTE : < 2-8 WEEKS SUBACUTE : 2-8 WEEKS 12 WEEKS CHRONIC : > 12 WEEKS
6 etiology Non-specific mechanical back pain Facet joint syndrome Lumbar disc degeneration (lumbar spondylosis) Lumbar disc prolapse Spondylolisthesis Spinal stenosis Osteoporosis Sero-negative spondyl arthritis (including ankylosing spondylitis) Vertebral infection Disc space infection Malignancy secondary myeloma and primary Paget s disease, referred-visceral, pancreatic/pelvic, etc
7 RED FLAGS POSSIBLE SERIOUS SPINAL PATHOLOGY Age of onset : < 20 or 55 years Violent trauma, eg fall from a height, traffic accident Constant, progressive, non-mechanical pain Thoracic pain History of carcinoma Systemic steroids Drug abuse, HIV infection Systemically y unwell Weight loss Persistent severe restriction of lumbar flexion Widespread neurological deficit Structural deformity
8 COMMON ETIOLOGY 1. Mechanical (deformity, trauma) 2. Inflammation 3. Neoplasm 4. Degenerative 5. Psychological
9
10 LBP in pregnancy
11 PRIMARY MECHANICAL DEARRANGEMENT Ligamentous Strain Muscle strain or spasm Facet join disruption or degeneration Intervertebral disc degeneration or herniation Vertebral compression fracture Vertebral end-plate microfractures Spondylolisthesis Spinal stenosis Diffuse idiopathic skeletal hyperostosis
12
13 THE DISTINCTION AMONG SPONDYLOSIS, SPONDYLOLISIS AND SPONDYLOLISTHESIS SPONDYLOSIS : refers to osteoarthritis involving the articular surfaces (joints and discs) of the spine, often with osteophyte formation and cord or root compression SPONDYLOLISIS : refers to a separation at the pars articularis, which permits the vertebrae to slip. Maybe uni or bilateral
14 THE DISTINCTION AMONG SPONDYLOSIS, SPONDYLOLISIS AND SPONDYLOLISTHESIS SPONDYLOLISTHESIS : May result from bilateral pars defects or degenerative disc disease. Defined as the anterior subluxation of the suprajacent vertebrae, often producing central canal stenosis : it is the slipping i forward of one vertebrae on the vertebrae below.
15 INFECTION Epidural abcess Vertebral osteomyelitis Septic discitis Pott s disease (tuberculosis) Nonspecific manifestation of systemic illness
16 NEOPLASM Epidural or vertebral carcinomatous metastases Multiple myeloma Lymphoma
17 DEGENERATIVE 1. Osteoarthritis 2. Rheumatoid arthritis 3. Thoracic Outlet Syndrome 4. Cervical Spondylosis 5. Marie-Strumpell disease 6. Lumbar disc prolaps p (Hernia Nukleus Pulposus (HNP) 7. Spinal Stenosis
18 RADICULOPATHY ESSENTIALS of DIAGNOSIS : Pain in a dermatomal distribution, sensory symptoms along the same dermatome, weakness in a corresponding myotomal distribution, and absent or depressed reflexes. Frequency of incidence in order of occurrence : lumbar > cervical > thoracic Usually caused by a herniated disk or by spondylosis; other causes are infection, neoplasm, granuloma, cyst, and hematoma
19 Lumbar disc prolaps The earliest change in the NP and AF are probably biochemical and may be part of aging Superimposed trauma accelerates these degenerative changes The laters of fthe AF separate and dform circumferential ltear, leads to radial tears. NP may extrude producing disc herniation or prolaps Multiple tears produce weakening and circumferential bulging of the AF with loss of disc height Further disc narrowing results from aging of the NP, which changes from gelatinous consistency int the childhood to a fibrotic consistency in adulthood
20 The disk
21
22 Herniated disc
23 Distribution Lumbar disc prolaps (most common) L5-S1 (45-50%), L4-5 (40-45%) Cervical disc prolaps C6-7 (69%), C5-6 (19%) Thoracal disc prolaps (infrequent, < 1%)
24 Lumbar Disc Prolaps : Grade Protruded ddisk : penonjolan jl nukleus pulposus tanpa kerusakan annulus fibrosus Prolapsed disk : nukleus berpindah tetapi tetap dalam lingkaran annulus fibrosus. Extruded disk : nukleus keluar dari annulus fibrosus dan berada di bawah ligamentum longitudinalis posterior. Sequestrated disk : nukleus telah menembus ligamentum longitudinalis posterior.
25 Grade of herniated disc
26 Clinical symptoms Lumbar HNP : * severe LBP and lumbar paraspinal spasms, with pain radiating to the buttocks, legs, and feet (radicular pain) * abnormal vertebral posture * paresthesia, parese, diminished tendon reflexes * pain, sensory loss and weakness typically occur in a radicular pattern. * urinary symptoms, if present, reqquire immediate attention
27 Ischialgia (sciatic)
28 Clinical symptoms Cervical HNP : * pain present in the posterior neck, with spasm of the cervical paraspinal p musculature and near or over the shoulder blades on the affected side. * radicular pain, aggravated by neck extension, coughing, straining, i laughing, bending, or turning the neck to the side; and reduced by abducting the arm and put it behing the head * paresthesia, parese, diminished tendon reflexes
29 Diagnosis : Neurological examination Lumbar HNP : * Lasegue (straight leg raising) test. A positive SLR test is a sensitive indicator of nerve root irritation (sensitivity 95%)., May be positive with disc protrussion, intraspinal tumor or inflammatory radiculopathy * Crossed Laseque (crossed SLR) test. Less sensitive but highly specific. * Femoral stretch (reverse SLR) test. May detect an L2-4 root or femoral nerve irritation.
30 Diagnosis : Neurological examination Cervical HNP : * Lhermitte s sign A painless but unpleasant tingling or electric shock- like sensation in the back and spreading instantaneously down the arms and legs following neck flexion (active or passive) * Spurling ssign sign Increase in arm pain (brachialgia) associated with compressive cervical radiculopathy following neck rotation and flexion to the side of pain. * Shoulder abduction test
31 Diagnosis RADIOLOGICAL EXAMINATION : Plain vertebral x-rays : * limited information * disc narrowing, scoliosis, lordosis lumbal Myelography y CT or CT-myelography MRI : the best imaging study EMG/NCV : 90% abnormal after 1-2 weeks
32 MRI scan shows L4-5 herniated disc
33 Therapy : Conservative * bed rest : max 2 days recommended * Pharmacotherapy : -NSAID -short course of corticosteroid t idfor acute herniated itd disc (controversial) - muscle relaxant - for neuropathic pain : gabapentin, 5% lidocaine i patch, tramadol, TCA. * Nonpharmacologic therapy : - heat, ice, massage, stress reduction, activity limitation, postural modification, physical therapy program - soft cervical collar or lumbar corset
34 Therapy :Operative The few absolute indications : 1. Marked muscular weakness pertaining to a nerve root or roots. 2. Progressive neurologic deficits. 3. Cauda equina syndrome with urinary symptoms 4. Pain that has existed for more than 4 months, has not responded dd to conservative treatment, and interferes with normal function.
35 LUMBAR SPINAL STENOSIS CLINICAL SYMPTOMS : neurogenic intermittent claudiation or pseudoclaudication (most frequent) usually bilateral, but maybe unilateral a dull, aching pain the whole lower extremity is generally affected pain provoked by walking and standing, quickly relieved by sitting or leaning forward LBP presents in 65% patients with lumbar spinal stenosis radicular pain is the least common manifestation
36
37 MOST FREQUENT CAUSES OF SPINAL STENOSIS > 25 causes are identified The most common : 1. Idiopathic : the result of shorter than normal pedicles, thickened convergent lamina, and a convex posterior vertebral body. 2. Degenerative (50% of cases) : degenerative changes affect the facets posteriorly allowing instability and subluxation, osteophytes form and narrow the nerve root and the central canal ; and the disc anteriorly allowing the disc to bulge into the nerve root and central canal.
38 MOST FREQUENT CAUSES OF SPINAL STENOSIS 3. Degenerative spondylolisthesis : occurs when the facets degenerate, allowing slippage of fthe upper vertebrae forward over the lower vertebrae. 4. Postoperative : occurs after laminectomy or spinal fusion. Stenosis is produced by bone formation and scar tissue
39 INDICATION FOR SURGICAL TREATMENT OF LUMBAR SPINAL STENOSIS 1. Severe and disabling pain (persistent intolerable pain) 2. Limitation of walking distance or standing endurance to a degree that compromises necessary activities 3. Severe or progressive muscle weakness or disturbed bladder and bowel, or sexual function. 4. Poor response to at least 4 weeks of conservative treatment
40 THANK YOU
Degenerative Disease of the Spine
Degenerative Disease of the Spine Introduction: I. Anatomy Talk Overview II. Overview of Disease Processes: A. Spondylosis B. Intervertebral Disc Disease III. Diagnosis IV. Therapy Introduction: Myelopathy
More informationEpidemiology of Low back pain
Low Back Pain Definition Pain felt in your lower back may come from the spine, muscles, nerves, or other structures in that region. It may also radiate from other areas like the mid or upper back, a inguinal
More informationPeggers Super Summaries: The Aging Spine
Aging Spine: AGING PROCESS Osteopenia 10% of 50 year old males and 25% of 50 year females Disc dehydration Facet degeneration Soft tissue hypertrophy 2 0 deformity Leg pain worse than back pain from nerve
More informationCommon Thoraco- Lumbar Problems in the Mature Athlete
Common Thoraco- Lumbar Problems in the Mature Athlete Diana Heiman, MD Associate Professor, Family Medicine Residency Director East Tennessee State University Objectives Review the pathophysiology of the
More informationHIGH LEVEL - Science
Learning Outcomes HIGH LEVEL - Science Describe the structure and function of the back and spine (8a) Outline the functional anatomy and physiology of the spinal cord and peripheral nerves (8a) Describe
More information외래에서흔히접하는 요통환자의진단과치료 울산의대서울아산병원가정의학과 R3 전승엽
외래에서흔히접하는 요통환자의진단과치료 울산의대서울아산병원가정의학과 R3 전승엽 Index Introduction Etiology & Type Assessment History taking & Physical examination Red flag sign Imaging Common disorder Management Reference Introduction Pain
More informationBACK PAIN. Disclaimer. Integrated web marketing. Multimedia Health Education
BACK PAIN Disclaimer This movie is an educational resource only and should not be used to make a decision on. All decisions about surgery must be made in conjunction with your surgeon or a licensed healthcare
More informationOrthopadic cors. Topic : -Cervical spondylitis. -Development disorders(spondylolysis and Spodylolsithesis)
Orthopadic cors Topic : -Cervical spondylitis. -Development disorders(spondylolysis and Spodylolsithesis) Cervical spondylitis. Definition : - a painful condition of the cervical spine resulting from the
More informationNECK AND BACK PAIN AN INTRODUCTION TO
AN INTRODUCTION TO NECK AND BACK PAIN This booklet provides general information on neck and back pain. It is not meant to replace any personal conversations that you might wish to have with your physician
More informationSpine Conditions and Treatments. Your Guide to Common
Your Guide to Common Spine Conditions and Treatments The spine is made up of your neck and backbone. It allows your body to bend and move freely. As you get older, it is normal to have aches and pains.
More informationComprehension of the common spine disorder.
Objectives Comprehension of the common spine disorder. Disc degeneration/hernia. Spinal stenosis. Common spinal deformity (Spondylolisthesis, Scoliosis). Osteoporotic fracture. Anatomy Anatomy Anatomy
More informationThe ABC s of LUMBAR SPINE DISEASE
The ABC s of LUMBAR SPINE DISEASE Susan O. Smith ANP-BC University of Rochester Department of Neurological Surgery Diagnosis/Imaging/Surgery of Lumbar Spine Disorders Objectives Identify the most common
More informationSpineFAQs. Lumbar Spondylolisthesis
SpineFAQs Lumbar Spondylolisthesis Normally, the bones of the spine (the vertebrae) stand neatly stacked on top of one another. The ligaments and joints support the spine. Spondylolisthesis alters the
More informationObjectives. Comprehension of the common spine disorder
Objectives Comprehension of the common spine disorder Disc degeneration/hernia Spinal stenosis Common spinal deformity (Spondylolisthesis, Scoliosis) Osteoporotic fracture Destructive spinal lesions Anatomy
More informationSpineFAQs. Neck Pain Diagnosis and Treatment
SpineFAQs Neck Pain Diagnosis and Treatment Neck pain is a common reason people visit their doctor. Neck pain typically doesn't start from a single injury. Instead, the problem usually develops over time
More informationHERNIATED DISCS AN INTRODUCTION TO
AN INTRODUCTION TO HERNIATED S This booklet provides general information on herniated discs. It is not meant to replace any personal conversations that you might wish to have with your physician or other
More informationDEGENERATIVE SPONDYLOLISTHESIS
AN INTRODUCTION TO DEGENERATIVE SPONDYLOLISTHESIS This booklet is designed to inform you about lumbar degenerative spondylolisthesis. It is not meant to replace any personal conversations that you might
More informationCervical intervertebral disc disease Degenerative diseases F 04
Cervical intervertebral disc disease Degenerative diseases F 04 How is a herniated cervical intervertebral disc treated? Conservative treatment is generally sufficient for mild symptoms not complicated
More informationFrancine M. Pulver, MD, Clinical Assistant Professor Department of Physical Medicine & Rehabilitation Ohio State University Medical Center
Oh My Aching Back! Francine M. Pulver, MD, Clinical Assistant Professor Department of Physical Medicine & Rehabilitation Ohio State University Medical Center Epidemiology 90% of episodes of LBP resolves
More informationEVALUATE, TREAT AND WHEN TO REFER RED FLAGS Mid Atlantic Occupational Regional Conference and Environmental Medicine October 6, 2018
EVALUATE, TREAT AND WHEN TO REFER RED FLAGS Mid Atlantic Occupational Regional Conference and Environmental Medicine October 6, 2018 Marc J. Levine, MD Rothman Institute Director Spine Surgery Program
More informationCommon Conditions. Visit our homepage for more info >> TABLE OF CONTENTS. Bulging/Herniated Disc... PAGE 2. Cervical (Neck) Pain...
Common Conditions TABLE OF CONTENTS Bulging/Herniated Disc... PAGE 2 Cervical (Neck) Pain... PAGE 3 Degenerative Disc Disease... PAGE 4 Sciatica...PAGE 5 Spinal Stenosis... PAGE 6 Spondylolisthesis...
More informationAll About? What is Sciatica. Disclaimer. Integrated web marketing. Multimedia Health Education
What is Sciatica All About? Disclaimer This movie is an educational resource only and should not be used to manage sciatica. All decisions about the management of sciatica must be made in conjunction with
More informationLow back pain in a Nutshell Paul Manjaly. Paul Manjaly
Low back pain in a Nutshell Paul Manjaly Paul Manjaly Pain: An unpleasant sensory and emotional experience which follows actual or potential tissue damage or is described in terms of such damage Unpleasant
More informationRiver North Pain Management Consultants, S.C., Axel Vargas, M.D., Regional Anesthesiology and Interventional Pain Management.
River North Pain Management Consultants, S.C., Axel Vargas, M.D., Regional Anesthesiology and Interventional Pain Management. Chicago, Illinois, 60611 Phone: (888) 951-6471 Fax: (888) 961-6471 Clinical
More information8/4/2012. Causes and Cures. Nucleus pulposus. Annulus fibrosis. Vertebral end plate % water. Deforms under pressure
Causes and Cures Intervertebral discs Facet (zygopophyseal) joints Inter body joints Spinal nerve roots Nerve compression Pathological conditions Video Causes of back pain Nucleus pulposus Annulus fibrosis
More informationThe spine is made of a column of bones. Each bone, or vertebra, is formed by a round block of bone, called a vertebral body. A bony ring attaches to the back of the vertebral body. When the vertebra bones
More informationLumbar disc prolapse. Done by : Areej Al-Hadidi
Lumbar disc prolapse Done by : Areej Al-Hadidi Anatomy of IVD IVD is composed of two components: 1. anulus fibrosus : it is the outer fibrous layer (fibrocartilage ) **It is comressible &tough 2. nucleus
More informationPOSTERIOR CERVICAL FUSION
AN INTRODUCTION TO PCF POSTERIOR CERVICAL FUSION This booklet provides general information on the Posterior Cervical Fusion (PCF) surgical procedure for you to discuss with your physician. It is not meant
More informationVirginia Spine Institute - FAQs
Virginia Spine Institute - FAQs 1. What are common causes of back pain? Back pain is one of the most common ailments known to man. Approximately 80% of the adult population will develop a significant episode
More informationLUMBAR SPINAL STENOSIS
LUMBAR SPINAL STENOSIS Always occurs in the mobile segment. Factors play role in Stenosis Pre existing congenital or developmental narrowing of the lumbar spinal canal Translation of one anatomic segment
More informationRADICULOPATHY AN INTRODUCTION TO
AN INTRODUCTION TO RADICULOPATHY This booklet provides general information on radiculopathy. It is not meant to replace any personal conversations that you might wish to have with your physician or other
More informationThe main causes of cervical radiculopathy include degeneration, disc herniation, and spinal instability.
SpineFAQs Cervical Radiculopathy Neck pain has many causes. Mechanical neck pain comes from injury or inflammation in the soft tissues of the neck. This is much different and less concerning than symptoms
More informationLumbar Disc Prolapse. Dr. Ahmed Salah Eldin Hassan. Professor of Neurosurgery & Consultant spinal surgeon
Lumbar Disc Prolapse By Dr. Ahmed Salah Eldin Hassan Professor of Neurosurgery & Consultant spinal surgeon 1-What are the Functions of the Spine Structural support for upright posture Protection of Spinal
More informationHerniated Disk in the Lower Back
Herniated Disk in the Lower Back This article is also available in Spanish: Hernia de disco en la columna lumbar (topic.cfm?topic=a00730). Sometimes called a slipped or ruptured disk, a herniated disk
More informationEVALUATION AND MANAGEMENT OF CERVICAL SPINE DISORDERS
CERVICAL SPINE EVALUATION AND MANAGEMENT OF CERVICAL SPINE DISORDERS Gregory M Yoshida MD Supports the skull Allows movement of the head Houses the spinal cord CERVICAL SPINE Unique anatomy Upper C spine
More informationThe ABC s of LUMBAR SPINE DISEASE
The ABC s of LUMBAR SPINE DISEASE Susan O. Smith ANP-BC University of Rochester Department of Neurological Surgery URMC Neurosurgery APP s Objectives Identify the most common pathology that leads to spine
More informationDEGENERATIVE SPINAL DISEASE PRABIN SHRESTHA ANISH M SINGH B&B HOSPITAL
SPINAL CHAPTER, NESON DEGENERATIVE SPINAL DISEASE PRABIN SHRESTHA ANISH M SINGH B&B HOSPITAL INTRODUCTION DEGENERATIVE SPINAL DISEASE Gradual loss of normal structure and function of spine with time Also
More informationCoventry Pain Clinic - Spianl Pain - Sciatica and Brachalgia
Coventry Pain Clinic - Spianl Pain - Sciatica and Brachalgia Copyright 2002-2005 Dr. Richard S. Walker Introduction Spinal Nerve Root Pain (Radiculopathy) can arise from the problems affecting the:- C4
More informationUnderstanding your spine and how it works can help you better understand low back pain.
Low Back Pain Almost everyone will experience low back pain at some point in their lives. This pain can vary from mild to severe. It can be short-lived or long-lasting. However it happens, low back pain
More informationCERVICAL SPONDYLOSIS & CERVICAL DISC DISEASE
CERVICAL SPONDYLOSIS & CERVICAL DISC DISEASE Cervical spondylosis l Cervical osteophytosis l Most common progressive disease in the aging cervical spine l Seen in 95% of the people by 65 years Pathophysiology
More informationCox Technic Case Report #169 published at (sent 5/9/17) 1
Cox Technic Case Report #169 published at www.coxtechnic.com (sent 5/9/17) 1 Management of Lumbar Radiculopathy Associated with an Extruded L4 L5 disc and concurrent L5 S1 Spondylolytic Spondylolisthesis
More informationACDF. Anterior Cervical Discectomy and Fusion. An introduction to
An introduction to ACDF Anterior Cervical Discectomy and Fusion This booklet provides general information on ACDF. It is not meant to replace any personal conversations that you might wish to have with
More informationTHE LUMBAR SPINE (BACK)
THE LUMBAR SPINE (BACK) At a glance Chronic back pain, especially in the area of the lumbar spine (lower back), is a widespread condition. It can be assumed that 75 % of all people have it sometimes or
More informationNumb bum means cauda equina Per rectal examination is indicated to assess anal tone
SPINE Age and occupation Pain: Where: Low back or leg Which is worse? Where about in the leg? Describe the radiation How long? More than 6 wks need warrant evaluation How the pain is now compared to the
More informationUnderstanding Back Pain
Understanding Back Pain Back pain affects the vast majority of Americans Back pain is second only to the common cold for the medical complaint doctors hear most often and for causing people to miss the
More informationCommon Orthopedic Conditions of the Spine
Common Orthopedic Conditions of the Spine Learning Objective Given a scenario describing a patient with symptoms suggestive of an orthopedic or musculoskeletal condition, formulate a treatment plan after
More informationRETROLISTHESIS. Retrolisthesis. is found mainly in the cervical spine and lumbar region but can also be often seen in the thoracic spine
RETROLISTHESIS A retrolisthesis is a posterior displacement of one vertebral body with respect to adjacent vertebrae Typically a vertebra is to be in retrolisthesis position when it translates backward
More informationPrimary care referral criteria for musculoskeletal MRI scans
Appendix 1 Primary care referral criteria for musculoskeletal MRI scans Accepted Criteria for Direct Access MRI Body Part Symptoms Imaging indicated Lumbar Spine Low Back Pain with adverse symptoms or
More informationOverview Anatomy of the spinal canal What is spinal stenosis? > 1
1 Spinal Stenosis Overview Spinal stenosis is the narrowing of the bony space (canals) through which the nerves and spinal cord pass. Arthritis can cause the facet joints and ligaments to enlarge and thicken
More informationProDisc-L Total Disc Replacement. IDE Clinical Study.
ProDisc-L Total Disc Replacement. IDE Clinical Study. A multi-center, prospective, randomized clinical trial. Instruments and implants approved by the AO Foundation Table of Contents Indications, Contraindications
More informationAlan H Daniels, MD. Spine Division, Department of Orthopaedics Warren Alpert School of Medicine of Brown University
Spinal and Orthopaedic Surgery in the Elderly Alan H Daniels, MD Spine Division, Department of Orthopaedics Warren Alpert School of Medicine of Brown University As the population ages, and patients remain
More informationDiscal herniation and spondylosis
III.8.4.6 Degenerative disorders of the spine Introduction the frequency of locomotor disorders increases with age Low back pain is a very common disorder. According to medical literature, it is the second
More informationSpine Pain Management Program
Spine Pain Management Program Please complete the following information: Patient Name: Patient ID Number: Patient DOB: The procedure being requested: Epidural Injection Please check the indication (reason)
More informationDISORDERS OF THE SPINE TREATING PHYSICIAN DATA SHEET
DISORDERS OF THE SPINE TREATING PHYSICIAN DATA SHEET Short form FOR REPRESENTATIVE USE ONLY REPRESENTATIVE S NAME AND ADDRESS REPRESENTATIVE S TELEPHONE REPRESENTATIVE S EMAIL PHYSICIAN S NAME AND ADDRESS
More informationSpinal Stenosis Surgical
Spinal Stenosis Surgical Disclaimer This movie is an educational resource only and should not be used to make a decision on. All decisions about surgery must be made in conjunction with your surgeon or
More informationSpine Pain Management Program
Spine Pain Management Program Please complete the following information: Patient Name: Patient ID Number: Patient DOB: The procedure being requested: Epidural Adhesiolysis Please check the indication (reason)
More informationVERTEBRAL COLUMN ANATOMY IN CNS COURSE
VERTEBRAL COLUMN ANATOMY IN CNS COURSE Vertebral body Sections of the spine Atlas (C1) Axis (C2) What type of joint is formed between atlas and axis? Pivot joint What name is given to a fracture of both
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Acetaminophen, in neck pain, 505 506 Acupuncture, chi and, 524 for mechanical neck disorders, 525 in neck pain, 524 525 safety of, 525 Adson
More informationA Patient s Guide to Cervical Radiculopathy
A Patient s Guide to Cervical Radiculopathy 950 Breckinridge Lane Suite 220 Louisville, KY 40223 Phone: 502.708.2940 DISCLAIMER: The information in this booklet is compiled from a variety of sources. It
More informationSpine Pain Management Program
Spine Pain Management Program Please complete the following information: Patient Name: Patient ID Number: Patient DOB: The procedure being requested is: Please check the indication (reason) for this procedure
More informationSpinal Cord Injuries: The Basics. Kadre Sneddon POS Rounds October 1, 2003
Spinal Cord Injuries: The Basics Kadre Sneddon POS Rounds October 1, 2003 Anatomy Dorsal columntouch, vibration Corticospinal tract- UMN Anterior horn-lmn Spinothalamic tractpain, temperature (contralateral)
More informationHailee Gibson, CCPA Neurosurgery Physician Assistant. Windsor Neurosurgery & Spine Associates. Windsor Regional Hospital Ouellette Campus
Hailee Gibson, CCPA Neurosurgery Physician Assistant Windsor Neurosurgery & Spine Associates Windsor Regional Hospital Ouellette Campus Disclosures I have no disclosures Learning Objectives Provide information
More informationCervical Spine in Baseball
Cervical Spine in Baseball Robert G Watkins, IV, MD Co-Director, Marina Spine Center Marina del Rey, CA Vice Chief of Staff Cedars-Marina del Rey Hospital Disclosures n Pioneer / RTI Consulting, Royalties
More informationSpine Pain Management Program
Spine Pain Management Program Please complete the following information: Patient Name: Patient ID Number: Patient DOB: The procedure being requested: Facet Injection Please check the indication (reason)
More informationPatient Information ACDF. Anterior Cervical Discectomy and Fusion
Patient Information ACDF Anterior Cervical Discectomy and Fusion Table of Contents Anatomy of the Spine...2-3 General Conditions of the Cervical Spine...4 5 What is an ACDF?...6 How is an ACDF performed?...7
More informationLumbar Spinal Stenosis
Lumbar Spinal Stenosis This article is also available in Spanish: Estenosis de la columna lumbar (topic.cfm?topic=a00701). A common cause of low back and leg pain is lumbar spinal stenosis. As we age,
More informationwww.fisiokinesiterapia.biz NOTE : THIS PRESENTATION DOES NOT REPLACE ATTENDANCE OR INFORMATION GIVEN IN THE LECTURE.IT IS INTENDED AS A HIGHLIGHT FOR THE TOPIC INTRODUCTION 60-80% of people will have LBP
More informationUniversity of Jordan. Professor Freih Abuhassan -
Freih Odeh Abu Hassan F.R.C.S.(Eng.), F.R.C.S.(Tr.& Orth.). Professor of Orthopedics University of Jordan 1 A. Sacroiliitis History Trauma is very common Repetitive LS motion--lumbar rotation or axial
More informationSpine. Neuroradiology. Spine. Spine Pathology. Distribution of fractures. Radiological algorithm. Role of radiology 18/11/2015
Spine Neuroradiology Spine Prof.Dr.Nail Bulakbaşı X Ray: AP/L/Oblique Vertebra & disc spaces CT & CTA Vertebra, discs, vessels MRI & MRA Vertebra, disc, vessels, meninges Spinal cord & nerves Myelography
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Adolescent athlete, anatomy and biomechanics of spine of, 424 425 back pain in. See Back pain, in pediatric and adolescent athlete. injury
More informationOutline. Introduction / Epidemiology. Anatomy / Pain generators. Diagnosis. Treatment. Most Important lecture!!
Acute Low Back Pain Outline Introduction / Epidemiology. Most Important lecture!! Anatomy / Pain generators Diagnosis Treatment Course Objectives Know the RED FLAGS in history taking. Know the Pain Generators
More informationPatient Information MIS TLIF. Transforaminal Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques
Patient Information MIS TLIF Transforaminal Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques MIS TLIF Table of Contents Anatomy of Spine..............................................
More informationThoracolumbar Spine Conditions: Treatment and Return to Play
Thoracolumbar Spine Conditions: Treatment and Return to Play C H R I S T O P H E R B U R K S, MD B I E N V I L L E O R T H O P A E D I C S P E C I A L I S T S O C E A N S P R I N G S, MS Thoracolumbar
More informationSurgery. Conus medullaris and Cauda Equina Syndromes. Anatomy. See online here
Surgery Conus medullaris and Cauda Equina Syndromes See online here Conus medullaris and cauda equina syndromes are spinal cord injuries that involve injury to the lumbosacral segment of the spinal cord.
More informationLUMBAR SPINE CASE 3. Property of VOMPTI, LLC. For Use of Participants Only. No Use or Reproduction Without Consent 1. L4-5, 5-S1 disc, facet (somatic)
LUMBAR SPINE CASE 3 A.J. Lievre, PT, DPT, OCS, CMPT Aaron Hartstein, PT, DPT, OCS, FAAOMPT Orthopaedic Manual Physical Therapy Series Richmond 2018-2019 L4-5, 5-S1 disc, facet (somatic) L5/S1 Radiculopathy
More informationPatient Information MIS LLIF. Lateral Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques
Patient Information MIS LLIF Lateral Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques Table of Contents Anatomy of Spine....2 General Conditions of the Spine....4 What is Spondylolisthesis....5
More informationA.J. Lievre, PT, DPT, OCS, CMPT Aaron Hartstein, PT, DPT, OCS, FAAOMPT
LUMBAR SPINE CASE #3 A.J. Lievre, PT, DPT, OCS, CMPT Aaron Hartstein, PT, DPT, OCS, FAAOMPT Orthopaedic Manual Physical Therapy Series Charlottesville 2017-2018 L4-5, 5-S1 disc, facet (somatic) L5/S1 Radiculopathy
More informationAm I eligible for the TOPS study? Possibly, if you suffer from one or more of the following conditions:
Am I eligible for the TOPS study? Possibly, if you suffer from one or more of the following conditions: Radiating leg pain Greater leg / buttock pain than back pain Severe pain sets in when walking as
More informationA Patient s Guide to Neck Pain. William T. Grant, MD
A Patient s Guide to Neck Pain Dr. Grant is a talented orthopedic surgeon with more than 30 years of experience helping people return to their quality of life. He and GM Pugh, PA-C pride themselves in
More informationNorth American Spine Society Public Education Series
Herniated Cervical Disc North American Spine Society Public Education Series What Is a Herniated Disc? The backbone, or spine, is composed of a series of connected bones called vertebrae. The vertebrae
More informationPaul Allan Regional Clinical Lead - South. Lumbar Spine. Assessment & Differential Diagnosis
Paul Allan Regional Clinical Lead - South Lumbar Spine Assessment & Differential Diagnosis Aims Refresh lumbar spine anatomy Red flags Discuss common pathologies seen in general practice Subjective and
More informationSpinal canal stenosis Degenerative diseases F 06
What is spinal canal stenosis? The condition known as spinal canal stenosis is a narrowing (stenosis) of the spinal canal that in most cases develops due to the degenerative (wear-induced) deformation
More informationNorth American Spine Society Public Education Series
Herniated Lumbar Disc North American Spine Society Public Education Series What Is a Herniated Disc? The spine is made up of a series of connected bones called vertebrae. The disc is a combination of strong
More informationRegional Pain Syndromes: Neck and Low Back
Regional Pain Syndromes: Neck and Low Back Srinivas Nalamachu, MD Disclosures Consultant/Independent Contractor/Honoraria: Ferring 1 Learning Objectives Identify the most common painful conditions in the
More informationPatient Information MIS TLIF. Transforaminal Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques
Patient Information MIS TLIF Transforaminal Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques MIS TLIF Table of Contents Anatomy of Spine...2 General Conditions of the Spine...4 6 MIS-TLIF
More informationDiagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society
Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society Annals of Internal Medicine October 2007 Volume 147,
More informationCervical and Thoracic Spinal Conditions Chapter 11
Cervical and Thoracic Spinal Conditions Chapter 11 Anatomy Spinal column Vertebrae Cervical (7) convex anteriorly Thoracic (12) concave anteriorly Lumbar (5) convex anteriorly Sacral (5 fused) concave
More informationLumbar spinal canal stenosis Degenerative diseases F 08
What is lumbar spinal canal stenosis? This condition involves the narrowing of the spinal canal, and of the lateral recesses (recesssus laterales) and exit openings (foramina intervertebralia) for the
More informationCervical Plating BACK PAIN
BACK PAIN Back Pain Back pain is frequent complaint. It is the commonest cause of work-related absence in the world. Although back pain may be painful and uncomfortable, it is not usually serious. Even
More informationEvaluation and Management of Select Spine Conditions
Evaluation and Management of Select Spine Conditions Michael E. Zychowicz, DNP, ANP, ONP, FAAN, FAANP Professor & Director, MSN Program Lead Faculty, Orthopedic NP Specialty Director, Duke-Durham VA Nursing
More informationPARADIGM SPINE. Patient Information. Treatment of a Narrow Lumbar Spinal Canal
PARADIGM SPINE Patient Information Treatment of a Narrow Lumbar Spinal Canal Dear Patient, This brochure is intended to inform you of a possible treatment option for narrowing of the spinal canal, often
More informationA Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH)
A Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH) 6565 Fannin Street Houston, TX 77030 Phone: 713-790-3333 DISCLAIMER: The information in this booklet is compiled from a variety of sources.
More informationeck and Low ack pain: ddressing he Surgical valuation
eck and Low ack pain: ddressing he Surgical valuation KI FOX, DO T WORTH BRAIN & SPINE Goals Review anatomy Identify sources of pain Imaging: the good, the bad, and the ugly PE: findings to determine source
More informationPatient Information MIS LLIF. Lateral Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques
Patient Information MIS LLIF Lateral Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques Table of Contents Anatomy of Spine...2 General Conditions of the Spine....4 What is Spondylolisthesis....5
More informationDIAGNOSIS CODING ESSENTIALS FOR LONG-TERM CARE: CHAPTER 13, M CODES MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE
DIAGNOSIS CODING ESSENTIALS FOR LONG-TERM CARE: CHAPTER 13, M CODES MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE Preferred Clinical Services for Leading Age Florida August 26-27, 2015 MUSCULOSKELETAL FUNCTIONS
More informationLigaments of the vertebral column:
In the last lecture we started talking about the joints in the vertebral column, and we said that there are two types of joints between adjacent vertebrae: 1. Between the bodies of the vertebrae; which
More informationFacet Joint Syndrome / Arthritis
Facet Joint Syndrome / Arthritis Overview Facet joint syndrome is an arthritis-like condition of the spine that can be a significant source of back and neck pain. It is caused by degenerative changes to
More informationGary Rea MD PhD Medical Director OSU Comprehensive Spine Center
Gary Rea MD PhD Medical Director OSU Comprehensive Spine Center 1. The less specific the patient is about symptoms and pain, the less likely a specific diagnosis will be made and the less likely the patient
More informationWendy Field Advanced Physiotherapy Practitioner June 2018
Wendy Field Advanced Physiotherapy Practitioner June 2018 Radiculopathy???? Lumbar radicular pain is where the clinician suspects the pain is coming from a lumbar nerve root. Essentially we are looking
More informationNon-Operative Management of Low Back Pain in the Elderly
www.4-no-pain.com Non-Operative Management of Low Back Pain in the Elderly Brian Kahan, D.O., FAAPMR Low Back Pain Outline Etiologies Initial Assessment Physical examination and Diagnostic work-up Clinical
More information