Diseases of the Spinal Cord and Nerve Roots (Surgical)

Question 1

where does the spinal cord extend from?

Answer 1

C1 - L2

Question 2

fill in the missing blanks

Answer 2

Question 3

fill in the blanks

Answer 3

Question 4

what happens with a C5 spinal cord lesion

Answer 4

Weakness in shoulder and below

Sensory level at C5

Increased tone in legs

Brisk reflexes

Babinski +ve

Myelopathy (UMN)

Neurological deficit due to compression of spinal cord

Question 5

what happens with L4 nerve root lesion?

Answer 5

Pain down ipsilateral leg

Numbness in L4 dermatome

Weakness in ankle dorsiflexion

Reduced knee jerk

Radiculopathy (LMN)

Compression of nerve root leading to dermatomal and myotomal deficits

Question 6

shat is the management of disc prolapse?

Answer 6

rehab

nerve root inject

lumbar/cervical discectomy

Question 7

what are the red flags for cauda equina syndrome?

Answer 7

–Bilateral sciatica

–Saddle anaesthesia

–Urinary dysfunction

Question 8

what are the first things to do with cauda equina syndrome?

Answer 8

•Requires urgent MRI

•

•Emergency lumbar discectomy

Question 9

what is disc prolapse?

Answer 9

Acute herniation of intervertebral disc causing compression of spinal roots or spinal cord

Question 10

who is likely to get disc prolapse?

Answer 10

younger patients

Question 11

who is likely to get loss of normal spinal structure?

Answer 11

seen in older patients

Question 12

what is loss of normal spinal structure a product of?

Answer 12

disc prolapse

ligamentum hypertrophy

osteophyte formation

Question 13

what is cervical spondylosis?

Answer 13

•Umbrella term for degenerative change in cervical spine leading to spine and nerve root compression

Question 14

how does a patient present with cervical spondylosis?

Answer 14

with either myelopathy or radiculopathy

Question 15

what is the management of cervical spondylosis?

Answer 15

–Conservative if no/mild myelopathy

–

–Surgery for progressive moderate to severe myelopathy

–

–Anterior and posterior approaches

Question 16

what is lumbar stenosis?

Answer 16

Pain down both legs ‘spinal claudication

Question 17

how is lumbar spinal stenosis worsend or relieved?

Answer 17

•Worse on walking/standing and relieved by sitting or bending forward

Question 18

what is the management of lumbar spinal stenosis?

Answer 18

lumbar laminectomy

Question 19

what are the intradural spinal tumours?

Answer 19

meningioma

neurofribroma

lipoma

Question 20

what are the intramedullary spinal tumours?

Answer 20

•Astrocytoma

•

•Ependymoma

•

•Teratoma

•

•haemangioblastoma

Question 21

how does a patient present with malignant cord progression?

Answer 21

patient presents with pain, weakness, sphincter disturbance

Question 22

what are the different type of spinal infections?

Answer 22

osteomyelitis

discitis

epidural abscess

Question 23

what is osteomyelitis?

Answer 23

infection within vertebral body

Question 24

what is discitis?

Answer 24

infection of intervertebral disc

Question 25

what is epidural abscess?

Answer 25

infection in the epidural space

Question 26

what are the risk factors of epidural abscess?

Answer 26

IV drug abuse

diabetes

chronic renal failure

alcoholism

Question 27

what are the organisms present in epidural abscesses?

Answer 27

staph aureus

streptococcus

e coli

Question 28

what is the management of epidural abscess

Answer 28

urgent surgical decompression and long term IV antibiotics

Question 29

what are the risk factors of osteomyelitis?

Answer 29

•IV drug abuse, diabetes, chronic renal failure, alcoholism, AIDS

Question 30

what is the management of osteomyelitis?

Answer 30

antibiotics

surgery if evidence of neurology