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46 Cards in this Set

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  • Back
If a pt presents and you notice that there is no separation of the facet joints (they are fused), what do you expect the shape of the patient's spine to be?
Increased lordosis
Vertebrae that fail to separate; no intervertebral disc
Block vertebrae
What is the net result of block vertebrae?
Premature degenerative disc disease and segmental instability
What is the treatment for hemivertebrae in children?
Surgical excision of the hemivertebra
Which vertebral segment is subject to more congenital anomalies than any other bone in the body?
What are common skin conditions association with lumbar anomalies?
Hairy nevus (fawn's beard)
Pigmented nevus
Lipomatous mass
Dermal Sinus
Where does facet tropism most commonly occur?
Lumbosacral junction
What is the most common anomaly in the lumbar region?
Zygapophyseal Tropism
Name the skeletal anomalies that occur in multiple regions of the spine
Block Vertebrae
Other Failure of Segmentation Anomalies
Hemi Vertebrae
Spina Bifida Occulta
Hemangioma Vertebra
what does a block vertebrae feel like on palpation
severe articular restriction
what is the net result of a blocked vertebrae
premature degenerative disc disease and segmental instability
how do you treat a blocked vertebrae
OMT and prolotherapy
in blocked vertebrae
the more normal the region the less wear and tear on the immediately adjacent disc levels
anterior failure fusion creates a
rigid kyphosis
unilateral bar vertebra create
posterior failure fusion creates
a abnormal lordosis
anterior vertebral agenesis is treated by
surgical reconfiguration of the spine up to age 25 at the latest
Why is it too late to fix a anterior vertebral agenesis after age 25
b/c the soft tissues in front of the spine are now shaped to the dysfx
What are hemivertebra
half vertebrae
-one side forms and 1 does not
-may produce a scoliotic curve
How do you treat a hemivertebra
surgical excision in early childhood
-heel lift later in life
What is the goal of treatment of hemivertebra
minimize the mechanical stress on the spine as a whole
Why is OMT used to treat hemivertebra
-to keep spine mobile prior to surgery or to help body adapt to heel lift
what is a common soft tissue abnormality
hemangioma vertebra
what are the characteristics of a hemangioma vertebra
-usually involves the vertebral body and is striated in appearance
is the hemangioma symptomatic
If the hemangioma is symptomatic how do you treat it
with radiation therapy
Name the types of lumbar anomalies
facet tropism
transitional lumbosacral segment
spina bifida
low intercrestal line
Which lumbar vertebra is subject to a greater number of congenital anomalies than any other bone
how do lumbar anomalies affect the body
affect motion and create the tendency for recurrent dysfunction and later degenerative disease
What accompanies many lumbar anomalies
congenital anomalies of the skin
what are the congenital skin anomalies associated with lumbar anomalies
hairy nevus(fawn's beard)
pigmented nevus
lipomatous mass
dermal sinus
where are facet tropisms most common
at the lumbosacral junction
What is the most common anomaly in the lumbar region
zygapophyseal tropism
What does tropism mean
the facet joint has turned away form its normal anatomic position
what is the orientation for the facets in facet tropism
cuvilinear mostly in the sagital plane
what is the most common anomaly in facet tropism
where one or both facet joints have turned to the coronal plane
in facet tropism the facets form what type of angle with the sagital plane
40-60 degrees
in facet tropism when the segment becomes hypermobile what happens
low back pain which follows a facet or ligamentous pattern
asymmetric facet joint forces can produce
asymmetric disc degeneration leading to disc bulging or herniation to the side of the coronal facet.
how do you treat facet tropism
prolotherapy (if hypermobility dev)
What are the areas of greatest truncal rotation
hip joint range of motion and thoraco-lumbar motion
what are the other names for a trasitional lumbosacral segment
batwing vertebra
butterfly vertebra
parital sacrilization of L5
lumbarization of S1
how do you treat a transitional lumbosacral segment
traction,prolotherapy, neuronlysis
injection of corticosteroids into pseudoarthrosis
Unilateral batwing
-usually creates a scoliosis
what is a low intercrestal line
a line across the top of the iliac crests that usu falls at or above the inferior endplate of L4
how do you treat a low intercrestal line
aggressive exercise strengthening to the lumbar musculature & OMT