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Degenerative Lumbar Spine

Key Points Back pain worse with leaning forward = discogenic back pain Leg pain worse with leaning forward = herniated disc Back pain worse with extension = posterior elements (spondy) Leg pain worse with extension = stenosis Nicotine has increased effect of disc deterioration Vibratory 4-5 Hz (Truck Drivers) Most disc herniations are L4/5, L5/S1 (90+%) next up is L3/4…

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Degenerative Cervical Spine

Cervical Spondylosis degenerative changes facet arthropathy begins @ 40 years of age, by 60-70 years most men and women have it symptoms can be discogenic neck pain, radiculopathy, and/or myelopathy As disc ages decrease in disk hydration decreased chondroitin sulfate increased keratin sulfate Inflammatory mediators IL-1 TNF-alpha Most common at C5-6, next at C4-5 How to Classify Stenosis acquired or…

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Pars Defects, Spondylolysis, Spondylolisthesis | Lumbar Spine

Lumbar Spine Anatomy lamina superior/inferior articular processes (aka facet joint) spinous process transverse process Scotty dog (on oblique x-rays) - Look for pars defect nose - transverse process front leg - inferior articular process neck - pars interarticularis ear - superior articular process Biomechanics of soccer kick approach limb swing -hyperextension foot plant - hyperextension hip flexion, knee extension, and…

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