Diseases of the Spinal Cord and Nerve Roots (surgical) Flashcards
What is the extent of the spinal cord?
C1-L2
What are the characteristics of an upper motor neuron lesion?
Weakness
Increased reflexes
Increased tone
Babinski sign present
What are the characteristics of a lower motor neuron lesion?
Weakness Atrophy Decreased reflexes Decreased tone Fasciculations Babinski sign absent
How does a disc prolapse present?
Younger patients
Acute onset pain down leg or arm
Numbness and weakness in distribution of affected nerve root
How are disc prolapses investigated and managed?
MRI scan
Rehabilitation
Nerve root injection
Lumbar/cervical discectomy
What are the red flags for cauda equina syndrome?
Bilateral sciatica
Saddle anaesthesia
Urinary dysfunction
How is cauda equina syndrome investigated and managed?
Urgent MRI
Emergency lumbar discectomy
How is cervical spondylosis managed?
Conservative if no or mild myelopathy
Surgery for progressive moderate to severe myelopathy
What are the symptoms of lumbar spinal stenosis?
Pain down both legs- spinal claudication
Worse on walking/standing and relieved by sitting or bending forward
What are the common spinal infections?
Osteomyelitis
Discitis
Epidural abscess
What is the triad of symptoms of an epidural abscess?
Back pain
Pyrexia
Focal neurology
What are the risk factors for epidural abscesses?
IV drug abuse
Diabetes
Chronic renal failure
Alcoholism
What are the risk factors for osteomyelitis?
IV drug abuse Diabetes Chronic renal failure Alcoholism AIDS
