Back Pain

Surgery

Assumptions

Students have a working knowledge of musculoskeletal anatomy of the spine.
Students have a basic understanding of disease spread (neoplastic, infectious).
Knowledge Objectives

Through their reading and patient care experiences, at the end of the rotation students should be able to:

Describe the key manifestations of various back pain syndromes. Consider: acute vs. chronic, age and gender, occupational & recreational risk factors.
Recognize radicular pain symptoms (herniated disc) and correlate neurologic findings with neuroanatomic level of disease.
Develop a differential diagnosis, initial evaluation and treatment strategies for:
herniated disc
spondylosis / spondylolisthesis
scoliosis
osteoporosis & degenerative disc disease
primary & metastatic tumors of the spine
infectious: osteomyelitis, epidural and paraspinal abscess
traumatic (musculoskeletal strain, vertebral fractures/dislocation ± cord injury)
retroperitoneal sources (aortic aneurysm, GU sources, pancreatic disease).
Discuss the use of diagnostic studies available for evaluation of back and leg pain. Include spine radiographs, CT scan, MRI, bone scan, myelography, angiography.
Discuss the indications for surgical consultation and treatment in problems addressed above.
List potential complication of surgery on the spine as well as unique concerns for perioperative management and rehabilitation / recovery.
Describe methods for preservation of back function occupationally and during leisure activities as part of healthy lifestyles
Describe indicated screening studies for at risk populations: PSA, AAA, and osteoporosis.