Degenerative Spine

Question 1

What is the typical cause of a degenerative spine?

Answer 1

Ligamentum flavum overgrowth compressing the spinal cord.

Question 2

Which age group is more susceptible to lumbar spinal stenosis compared to disc prolapse?

Answer 2

Older age group

Question 3

What is this a presentation of?
Neurogenic claudication, relief by bending forwards (not with rest). Progressive bilateral leg pain, numbness, weakness. Limitation of walking distance. Bladder symptoms. Unremarkable examination.

Answer 3

Lumbar spinal stenosis

Question 4

What is the management for lumbar spinal stenosis?

Answer 4

1. Can trial analgesia and physiotherapy

2. Will need definitive management with decompressive laminectomy

Question 5

What is the pathophysiology of cervical spondylosis?

Answer 5

Degeneration of annulus fibrosis, osteophyte formation, thickened ligamentum flavum leads to narrowing of spinal canal and intervertebral foramina.

Question 6

What is this a presentation of?
Neck stiffness, crepitus on moving neck, stabbing/dull arm pain. Lhermitte’s sign. Signs of a radiculopathy or myelopathy.

Answer 6

Cervical spondylosis

Question 7

What is the management for cervical spondylosis?

Answer 7

1. MRI c-spine
2. Trail analgesia, encourage gentle exercise
3. Refer to neurosurgeons