Chapter 016. Back and Neck Pain (Part 1) ppsx

Back and Neck Pain Part 1 Harrison's Internal Medicine > Chapter 16.. Back and Neck Pain Back and Neck Pain: Introduction The importance of back and neck pain in our society is unders

Chapter 016 Back and Neck Pain

(Part 1)

Harrison's Internal Medicine > Chapter 16 Back and Neck Pain

Back and Neck Pain: Introduction

The importance of back and neck pain in our society is underscored by the following: (1) the cost of back pain in the United States is ~$100 billion annually, including direct health care expenses plus costs due to loss of productivity; (2) back symptoms are the most common cause of disability in those <45 years; (3) low back pain is the second most common reason for visiting a physician in the United States; and (4) ~1% of the U.S population is chronically disabled because

of back pain

The anterior portion of the spine consists of cylindrical vertebral bodies separated by intervertebral disks and held together by the anterior and posterior longitudinal ligaments

The intervertebral disks are composed of a central gelatinous nucleus pulposus surrounded by a tough cartilaginous ring, the annulus fibrosis; disks are responsible for 25% of spinal column length (Figs 16-1 and 16-2)

The disks are largest in the cervical and lumbar regions where movements

of the spine are greatest The disks are elastic in youth and allow the bony vertebrae to move easily upon each other Elasticity is lost with age The function

of the anterior spine is to absorb the shock of body movements such as walking and running

Figure 16-1

Vertebral anatomy (From A Gauthier Cornuelle, DH Gronefeld:

Radiographic Anatomy Positioning New York, McGraw-Hill, 1998; with permission.)

Figure 16-2

Spinal column (From: A Gauthier Cornuelle, DH Gronefeld:

Radiographic Anatomy Positioning New York, McGraw-Hill, 1998; with