Lumbar and Cervical Spine Flashcards

1
Q

What is mechanical back pain?

A

Recurrent relapsing back pain with no neurological symptoms

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2
Q

Give some causes of mechanical back pain

A
Obesity
Poor posture
Lack of physical activity
Depression
Prolapse
Spondylosis
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3
Q

How is mechanical back pain treated?

A

Analgesia

Physiotherapy

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4
Q

What part of the disc is affected in an acute disc tear?

A

Outer annulus fibrosis

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5
Q

What commonly causes an acute disc tear?

A

Lifting a heavy weight

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6
Q

What is the main symptom of an acute disc tear?

A

Severe back pain worse on coughing

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7
Q

How is an acute disc tear treated?

A

Analgesia

Physiotherapy

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8
Q

What occurs in sciatica?

A

The nucleosis pulposis impinges on an exiting nerve root

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9
Q

What are the symptoms of sciatica?

A

Dermatomal pain
Altered sensation
Reduced power

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10
Q

What occurs in bony nerve root entrapment?

A

OA of facet joints causes osteophytes to impinge on exiting nerve roots

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11
Q

How is bony nerve root entrapment treated?

A

Surgical decompression (trimming osteophytes)

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12
Q

What causes spinal stenosis?

A

Spondylosis, bulging discs and osteophytosis causes less space in cauda equina

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13
Q

The pain in spinal stenosis is relieved by walking uphill/downhill?

A

Uphill

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14
Q

How is spinal stenosis treated?

A

Physiotherapy
Weight loss
Surgical decompression

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15
Q

What occurs in cauda equina syndrome?

A

Large central disc prolapse compresses all cauda equina nerve roots

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16
Q

What are the symptoms of cauda equina syndrome?

A

Bilateral leg pain
Saddle anaesthesia
Altered bowel/bladder habit

17
Q

How is cauda equina syndrome investigated?

A

PR exam

MRI

18
Q

What is the treatment of cauda equina syndrome?

A

Urgent disectomy

19
Q

What are the red flag symptoms of back pain?

A

Back pain in patient <20 years
New back pain in patient >60 years
Constant severe pain worse at night
Systemic upset

20
Q

What are the symptoms of osteoporotic crush fractures?

A

Acute pain

Kyphosis

21
Q

What occurs in cervical spondylosis?

A

Spondylosis causes disc degeneration causing OA of facet joints

22
Q

What are the symptoms of cervical spondylosis?

A

Slow onset stiffness and neck pain

23
Q

What are the symptoms of a cervical disc prolapse?

A

Dermatomal shooting neuralgic pain

Loss of reflexes

24
Q

What two conditions can lead to cervical spine instability?

A

Down’s syndrome

Rheumatoid arthritis

25
Q

What occurs in cervical spine instability?

A

Atlanto-axial subluxation due to synovial joint destruction between atlas and dens

26
Q

How is cervical spine instability treated?

A

Collar

Surgical fusion