Low Back Pain in the Adult: Radiographic Studies
- plain radiographs:
- in low risk patients, radiographs are indicated if LBP does not improve after 6 weeks;
- low risk implies that the patient is between 18-50 years, acute onset, absence of night pain, no recent wt loss,
no neurologic symptoms;
- radiographs are helpful in diagnosing spondylosis or spondylolithesis, and destructive lesions (from tumor; or infection);
- dynamic radiographs:
- normal anterior and posterior translation from L1 to L5 is about 8% of length of vertebral body or about 3-4 mm;
- radiographic findings: (not necessarily indicative of pain)
- Schmorl's nodes
- spina bifida occulta;
- osteophytes and spurs:
- traction osteophytes (associated w/ instability)
- marginal syndesmophytes: (AS, Inflammortory bowel disease);
- non marginal syndesmophytes: (DISH, Reiters and Psoriasis)
- age related changes may include:
- loss of disk height
- vaccum phenomenon (loss of disc height leads to facet joint loading);
- end plate sclerosis
- facet arthropathy;
- relative indications: (for ordering x-rays in patients w/ back pain)
- age greater than 50 yrs;
- history of cancer;
- temp greater than 38;
- nerve deficit;
- recent wt loss;
- pain at rest;
- Spine radiographs in patients with low-back pain. An epidemiological study in men.
- Bone Scan:
- may help rule out infection or occult metastatic tumor;
- CT Myelogram:
- allows accurate assesment of lumbar stensosis;
- can detect far lateral disc herniation;
- MRI of Spine:
Electrophysiologic mapping of the segmental anatomy of the muscles of the lower extremity.
Recognizing specific characteristics of nonspecific low back pain.
Advances in low-back pain.
Predictors of low back pain disability.
Predicting disability from low back pain.
The facet syndrome. Myth or reality
Medical Progress: Back Pain And Sciatica.
Back pain and sciatica.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Wednesday, April 11, 2012 4:08 pm