Back Pain Flashcards
What is Sciatica?
Pain on back of thigh and leg, coughing and sneezing aggravates it
Cause of Sciatica?
Lumbar disk prolapse
Majority of LDP occur at which level
L4-5, 5-S1
LDP history of concern before symptoms?
Falling or lifting heavy weights
If the LDP herniated laterally, what does it compress?
The root nerve next to it, this is called Radiculopathy.
When the LDP herniates centrally, what does it compress?
Cauda equina syndrome.
What clinical tests do we do for LDP?
Straight leg raising test (SLRT) and femoral stretch test (reverse SLRT)
What are the signs of radiculopathy?
Motor weakness, dermatomal sensory changes, and reflex changes
What is Lasegue’s sign, a result of SLRT exam
positive if the angle to which the leg can be raised (upon straight leg raising) before eliciting pain is <45°
Why do we do an Xray?
To rule out other pathologies
Why do we do an MRI?
Clearly shows the herniation
Why do we do a nerve conduction velocity and EMG?
To yield precise information on root nerve lesion
LDP surgery is urgent if?
Cauda equina syndrome, severe leg pain that doesn’t get relieved
Lumbar disk prolapse Urgent surgery/ Cauda equina basically
Open Laminectomy and Disectomy
Lumbar disk prolapse surgery?
Endoscopic disectomy
Lumbar canal stenosis clinical sign?
A sense of heaviness of both lower limbs
Investigation of lumbar canal stenosis?
CT and MRI scans.
Lumbar canal stenosis treatment?
Wide laminectomy and root decompression
What is Spondylolithesis?
A vertebrae sliding forward over another
Surgical treatment of Spondylolithesis?
Surgical decompression, and fusion of the involved levels
What is Spinal TB?
Osteomyelitis affects two or adjacent vertebral bodies, and destroys the vertebral space
What does spinal TB usually affect?
The dorsal vertebrae
What is the surgery to treat spinal TB if the antituberculosis drugs fail?
Excise granulated tissue, drain abscess, and remove the diseased vertebral body via anterolateral approach.
Spinal Abscess is extremely rare and requires urgent surgery, where is it most common??
Thoracic or Thoracolumbar region
