Dr.wrood2004
11-12-2002, 08:09 PM
the lower back pain common symptoms .. many of patient has such a thing...there is too many causes ..sometimes it maybe due to psychological cause ..
common cause of it is lumber prolapse..
Def: spinal pain due to
herniation of part of lumber invertebral disc.
sex: most common in men ..
age middle age unless it associated with trauma in young people.
site of prolapse: commonly between L3,L4 _ L4,L5 _L5,S1
pathology: part of gelatinous nucleus is pulposus protruds through the weakest part of the disc(postero-lateral) or some times it protrudes backward
symptoms:
acute presentation: symptoms usually follow trauma or lifting heavy things which cause sudden spin strain patient come with:
- acute back pain
-radiating pain (to leg) paresthesias and motor weakness
-sever bilateral root dysfunction lead to produce bowel and bladder incontinence and sexual dysfunction
chronic presentation: chronic intermittent exacerbations of back ache, without intial leg pain and the pain aggravated by activities and prolong sitting which increase intradiscal pressure and subside by rest
Signs: a) The paraspinal muscles are often in spasm, particularly on the side opposite the leg pain, and are tender to palpation. The patient leans away from the side of leg pain with the hip and knee flexed in an effort to reduce the leg pain.
Spinal movements are restricted due to pain.
b) Neurological examination may detect the motor, sensory, and reflex impairment (LMN type).
Diagnosis: MRI is the test of choice for evaluation of disc disease.
http://www.thamburaj.com/images/cervicalspondy/L5-S1.jpg http://www.thamburaj.com/images/cervicalspondy/L3-4-sag.JPG
Ct still usefull in such a patient.
Management:
medical: bed rest/ analgesic, antiinflammatory drugs.
surgical : the surgical procedure is lumbar discectomy Indications for it, include failure of acceptable pain control by nonoperative measures, progressive neurological deficit, and cauda equina syndrome.
regards
===
2004
common cause of it is lumber prolapse..
Def: spinal pain due to
herniation of part of lumber invertebral disc.
sex: most common in men ..
age middle age unless it associated with trauma in young people.
site of prolapse: commonly between L3,L4 _ L4,L5 _L5,S1
pathology: part of gelatinous nucleus is pulposus protruds through the weakest part of the disc(postero-lateral) or some times it protrudes backward
symptoms:
acute presentation: symptoms usually follow trauma or lifting heavy things which cause sudden spin strain patient come with:
- acute back pain
-radiating pain (to leg) paresthesias and motor weakness
-sever bilateral root dysfunction lead to produce bowel and bladder incontinence and sexual dysfunction
chronic presentation: chronic intermittent exacerbations of back ache, without intial leg pain and the pain aggravated by activities and prolong sitting which increase intradiscal pressure and subside by rest
Signs: a) The paraspinal muscles are often in spasm, particularly on the side opposite the leg pain, and are tender to palpation. The patient leans away from the side of leg pain with the hip and knee flexed in an effort to reduce the leg pain.
Spinal movements are restricted due to pain.
b) Neurological examination may detect the motor, sensory, and reflex impairment (LMN type).
Diagnosis: MRI is the test of choice for evaluation of disc disease.
http://www.thamburaj.com/images/cervicalspondy/L5-S1.jpg http://www.thamburaj.com/images/cervicalspondy/L3-4-sag.JPG
Ct still usefull in such a patient.
Management:
medical: bed rest/ analgesic, antiinflammatory drugs.
surgical : the surgical procedure is lumbar discectomy Indications for it, include failure of acceptable pain control by nonoperative measures, progressive neurological deficit, and cauda equina syndrome.
regards
===
2004