Back Pain

Question 1

What is Sciatica?

Answer 1

Pain on back of thigh and leg, coughing and sneezing aggravates it

Question 2

Cause of Sciatica?

Answer 2

Lumbar disk prolapse

Question 3

Majority of LDP occur at which level

Answer 3

L4-5, 5-S1

Question 4

LDP history of concern before symptoms?

Answer 4

Falling or lifting heavy weights

Question 5

If the LDP herniated laterally, what does it compress?

Answer 5

The root nerve next to it, this is called Radiculopathy.

Question 6

When the LDP herniates centrally, what does it compress?

Answer 6

Cauda equina syndrome.

Question 7

What clinical tests do we do for LDP?

Answer 7

Straight leg raising test (SLRT) and femoral stretch test (reverse SLRT)

Question 8

What are the signs of radiculopathy?

Answer 8

Motor weakness, dermatomal sensory changes, and reflex changes

Question 9

What is Lasegue’s sign, a result of SLRT exam

Answer 9

positive if the angle to which the leg can be raised (upon straight leg raising) before eliciting pain is <45°

Question 10

Why do we do an Xray?

Answer 10

To rule out other pathologies

Question 11

Why do we do an MRI?

Answer 11

Clearly shows the herniation

Question 12

Why do we do a nerve conduction velocity and EMG?

Answer 12

To yield precise information on root nerve lesion

Question 13

LDP surgery is urgent if?

Answer 13

Cauda equina syndrome, severe leg pain that doesn’t get relieved

Question 14

Lumbar disk prolapse Urgent surgery?

Answer 14

Open Laminectomy and Disectomy

Question 15

Lumbar disk prolapse surgery?

Answer 15

Endoscopic disectomy

Question 16

Lumbar canal stenosis clinical sign?

Answer 16

A sense of heaviness of both lower limbs

Question 17

Investigation of lumbar canal stenosis?

Answer 17

CT and MRI scans.

Question 18

Lumbar canal stenosis treatment?

Answer 18

Wide laminectomy and root decompression

Question 19

What is Spondylolithesis?

Answer 19

A vertebrae sliding forward over another

Question 20

Surgical treatment of Spondylolithesis?

Answer 20

Surgical decompression, and fusion of the involved levels

Question 21

What is Spinal TB?

Answer 21

Osteomyelitis affects two or adjacent vertebral bodies, and destroys the vertebral space

Question 22

What does spinal TB usually affect?

Answer 22

The dorsal vertebrae

Question 23

What is the surgery to treat spinal TB if the antituberculosis drugs fail?

Answer 23

Excise granulated tissue, drain abscess, and remove the diseased vertebral body via anterolateral approach.

Question 24

Spinal Abscess is extremely rare and requires urgent surgery, where is it most common??

Answer 24

Thoracic or Thoracolumbar region

Question 25

An imaging modality is fast becoming the investigation of choice for spinal lesions, what is it?

Answer 25

MRI

Question 26

Spinal neoplasm treatment?

Answer 26

Operative Decompression followed by Radiation therapy