Back and Spine Injuries Flashcards
What is lumbago?
Low back pain
What are some causes of mechanical back pain?
Muscle or ligament sprain
Facet joint dysfunction
Sacroiliac joint dysfunction
Herniated disc
Spondylolisthesis
Scoliosis
Degenerative changes
What are red flag causes of back pain?
Spinal fracture
Cauda equina syndrome
Spinal stenosis
Ankylosing spondylitis
Spinal infection
What is sciatica?
Irritation of sciatic nerve
Unilateral pain from the buttock radiating down the back of the thigh to below the knee or feet
Paraesthesia, numbness
Motor weakness
What are the main causes of sciatica?
Herniated disc
Spondylolisthesis
Spinal stenosis
What is bilateral sciatica a red flag for?
Cauda equina syndrome
What type of disc prolapse is most common?
Lateral prolapse
What are the 4 types of disc problem?
Bulging- asymptomatic
Protrusion- annulus weak but intact
Extrusion- through annulus
Sequestration- desiccated disc material free in canal
Where are the majority of disc prolapses?
L4/L5/S1
What is cauda equina syndrome?
Compression of cauda equina
Surgical emergency
What causes compression in cauda equina?
Herniated disc
Tumours
Spondylolisthesis
Abscess
Trauma
What are the red flags for cauda equina?
Saddle anaesthesia
Loss of sensation in bladder and rectum
Urinary retention or incontinence
Faecal incontinence
Bilateral sciatica
Bilateral motor weakness in legs
Reduced anal tone
What is the management of cauda equina?
Immediate admission
Emergency MRI
Lumbar decompression surgery with 48 hours
What is spinal stenosis?
Narrowing of part of the spinal canal causing compression of the spinal cord or nerve roots
What is the most common type of spinal stenosis?
Lumbar
What are the 3 types of spinal stenosis?
Central stenosis- narrowing of central spinal canal
Lateral stenosis- narrowing of the nerve roots canals
Foramina stenosis- narrowing of the intervertebral foramina
What causes spinal stenosis?
Congenital
Degenerative
Herniated disc
Thickening of ligamentum flava
Spinal fractures
Spondylolisthesis
Tumours
What is spondylolisthesis?
Anterior displacement of a vertebra out of line with the one below
What is the presentation of spinal stenosis?
Claudication
Lower back pain
Buttock and leg pain
Leg weakness
Worse working down hills
What is the management of spinal stenosis?
Exercise and weight loss
Analgesia
Physio
Decompression surgery
What are complete spinal injuries?
- No motor or sensory function distal to lesion
- No anal squeeze
- No sacral sensation
- ASIA Grade A
- No chance of recovery
What are incomplete spinal injuries?
- Some function is present below site of injury
- More favourable prognosis
What are 2 types of complete spinal injury?
Tetraplegia/quadriplegia
Paraplegia
What are the features of quadriplegia?
All 4 limbs
Injury to cervical region
Resp. failure- phrenic nerve
Spasticity in limbs (UMN)
