Definitions
This structure, comprising two vertebrae, an intervertebral disc, ligaments, and facet joints, is known as....
What is a Functional Spinal Unit
These types of changes usually starts within the nucleolus pulposus
A-changes
The function of a normal nucleous pulposus
To act hydrostatically by transmitting evenly to the annulus fibrosus and end plates in every direction according to Pascal’s principle
Avulsions in the fibres of the annulus fibrosus that can either involve the fibres themselves or their insertions on the adjacent end plates
What are: Annular fissures
Facet joints are present at every spinal level EXCEPT __________.
C1- C2
Part of the intervertebral disc that is most often the first to undergo degenerative changes, leading to a decrease in intradiscal pressure.
What is the nucleus pulposus
In these changes, after affecting Nucleolus Pulposus, the degenerative process extends to the disc, annulus fibrosus, end plates and bone marrow of the adjacent vertebral bodies
B-changes
The intradiscal pressure of a healthy, prone position patient is most similar to:
1 - the Maximum inflated pressure of car tires
2 - the Maximum inflated pressure of a Basketball
3 - the Maximum inflated pressure of a Soccer Ball
The intradiscal pressure of a healthy, prone position patient is most similar to: 3- the Maximum inflated pressure of a Soccer Ball
Healthy prone patient: 91 kPa
Max Soccer Ball inflation: 111 kPa
Occurs when intradiscal pressure remains high and the annulus fibrosus is intact and the height of the disc preserved
What is: Disc bulging
This is called the yellow ligament because of the high content of yellow elastin, makes up about 60–70% of the extracellular matrix. It extends from the second cervical vertebra to the first sacral vertebra, thus connecting the two adjacent laminae.
What is the ligamentum flavum
a response to insults, such as mechanical or metabolic injury
What is a Degenerative change
In these changes, the degeneration eventually involves distant structures and lead to facet joint osteoarthritis, ligamentum flavum hypertrophy and spinal canal stenosis
C- Changes
In nucleus pulposus degeneration intradiscal pressure ___1___ and the annulus fibrosus acts like a __2__ solid to resist compression directly
1) Drops 2) Fibrosus
In nucleus pulposus degeneration intradiscal pressure drops and the annulus fibrosus acts like a fibrosus solid to resist compression directly
Is a common nonspecific term used to describe hypertrophic changes of the end plates (osteophytes) and facet joints.
What is Spondylosis
Reduces the diameter of the spinal canal posteriorly and is considered an important causative factor in the development of lumbar spinal stenosis.
Ligamentum flavum hypertrophy
A biomechanically related continuum of alterations evolving over time.
What is Spine degeneration
provide a constant balanced turnover within the nucleous pulposus: they synthesise and break down the proteoglycans for the nucleous pulposus matrix that holds the water and collagen for the annulus fibrosus
What are chondrocytes
Structural weakness of the annulus fibrosus may lead to the inability of the disc to maintain anatomical alignment and position can lead to:
What is instability and/or spondylolisthesis
These occur because of long-standing inflammatory changes secondary to persistent fluctuating or chronic hernia, which eventually may lead to extensive epidural scarring
What are: Focal complications
This refers to the diverse conditions that decrease the total area of the spinal canal, lateral recesses or neural foramina
Spinal canal stenosis
Degenerative processes that may include horizontal or segmental degeneration, or change the entire biomechanics of the adjacent functional spinal units.
What is adjacent segment disease
This approach allows providers to:
1) accurately characterize the process in the involved segment
(2) identify the sequence of degenerative changes and predict further abnormalities
(3) identify hidden or subtle abnormalities based on indirect signs
(4) assist clinicians in finding the source of pain or neurological symptoms
(5) identify the best treatment options for patients
Pathophysiology-based approach to assessing imaging findings
What is: the Vacuum phenomenon
This is most commonly seen in the lumbar spine and virtually never occurs in the thoracic spine-- the condition represents the result of severe disc degeneration. Functional flexion/extension radiographs are considered the gold standard for diagnosing
What is Degenerative spondylolisthesis
Factors that have a direct impact on cartilage and bone development resulting in advance degenerative changes in the spine, and are considered specific causses of degenerative changes.
- 2 part question
Metabolic causes of degenerative changes.
Can include: Mucopolysaccharidoses (Hunter syndrome, Sanfilippo syndrome, Morquio syndrome), diabetes mellitus and ochronosis