Back pain

Question 1

what is the sign called when there is pain on straight leg raise ?

Answer 1

Lesague’s Sign

Question 2

what signs would L4/5 → L5 Root Compression have?

Answer 2

Weak hallux extension ± foot drop
 In foot drop due to L5 radiculopathy, weak
inversion (tib. post.) helps distinguish from
peroneal N. palsy.
 ↓ sensation on inner dorsum of foot

Question 3

what signs would L5/S1 → S1 Root Compression have?

Answer 3

 Weak foot plantarflexion and eversion
 Loss of ankle-jerk
 Calf pain
 ↓ sensation over sole of foot and back of calf

Question 4

what investigation should be done for disc prolapse ?

Answer 4

MRI

Question 5

what direction of prolapse causes cauda equina syndrome ?

Answer 5

central

Question 6

what direction of prolapse causes radiculopathy ?

Answer 6

lateral

Question 7

what is the management of disc prolapse ?

Answer 7

Conservative: brief rest, mobilisation/physio
Medical: analgesia, transforaminal steroid injection Surgical: discectomy or laminectomy may be needed in cauda-equina syndrome, continuing pain or muscle weakness.

Question 8

what is spondylolisthesis?

Answer 8

displacement of one lumbar vertebrae on another

Question 9

what are some causes of spondylolisthesis ?

Answer 9

Congenital malformation  Spondylosis

 Osteoarthritis

Question 10

state some signs of spinal stenosis ?

Answer 10

Aching or heavy buttock and lower limb pain on walking
 Rapid onset
 May c/o paraesthesiae/numbness
 Pain eased by leaning forward (e.g. on bike)
pain on extension

Question 11

what treatment options are there for spinal stenosis ?

Answer 11

Corsets
 NSAIDs
 Epidural steroid injection
 Canal decompression surgery

Question 12

state 4 signs of cauda equina syndrome ?

Answer 12

Alternating or bilateral radicular pain in the legs
 Saddle anaesthesia
 Loss of anal tone
 Bladder ± bowel incontinence

Question 13

state 4 signs of cord compression

Answer 13

Bilateral pain: back and radicular
 LMN signs at compression level
 UMN signs and sensory level below compression
 Sphincter disturbance

Question 14

what is the treatment for abscesses in the spinal canal

Answer 14

Large prolapse: laminectomy / discectomy

 Tumours: radiotherapy and steroids

 Abscesses: decompression

Question 15

what is the treatment for large prolapses ?

Answer 15

Large prolapse: laminectomy / discectomy

Question 16

what is the Tx of tumours in the spinal canal

Answer 16

 Tumours: radiotherapy and steroids