tailieunhanh - 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 | 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 . population is chronically disabled because of back pain. Anatomy of the Spine 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 Posterior S pi nous Superior articular process Lamina Spinal canal Pedicle Body Transverse process A Anterior Source Fauci AS Kasper DL Braunwald E Hauser SL Longo DL Jameson JL Loscalio J Harrison s Principles of Intern a Medicine 17th Edition http Copyright The McGraw-Hill Companies Inc. All rights reset . .