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15 Cards in this Set

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  • Back
What four factors are prognostic for future back pain?
History of back pain
Smoker
>30 years old
Workmen's compensation case
In acute low back pain, when do 50% of patients recover? When do 90% of patients recover?
50% recover at 1 week
90% recover at 3 months
In acute sciatica, when do 50% if patients recover?
At 1 month
A program consisting of what two factors has been demonstrated to result in the best return to work?
Education
Aerobic conditioning
What three Minnesota Multiphasic Personality Inventory (MMPI) findings are predictors of poor recovery?
Hysteria
Hypochondriasis
Depression
What are the aggravating positions for degenerative disk disease (DDD) and instability?
DDD: worse with flexion
Instability: worse with extension
What are the general surgical treatment principles for DDD and instability?
DDD: treat with interbody techniques (remove painful disk)
Instability: treat with instrumented posterolateral fusion
What are the two classic symptoms of lumbar instability?
"Catch" with extension
Back pain
What are the radiographic instability criteria at L1-L4?
>4 mm motion
10 degrees angulation
. . .at L5-S1?
>6 mm motion
20 degrees angulation
What are the five Waddell signs? What is their clinical significance
Tenderness
Simulation
Distraction
Regional disturbance (stocking-glove)
Overreaction
Significance: be wary if >3 positive
How are impairment and disability defined? Which determines compensation?
Impairment: deviation from normal function
Disability: inability to perform a specific function
Disability more important for compensation
What is the proven benefit of a corset? What is its effect on motion?
Decreased intradiskal pressure
No effect on motion
Compare Jewett versus thoracolumbar spinal orthosis (TLSO) for rotational control.
TLSO better
How can L5-S1 best be immobilized?
TLSO