Lumbar and Cervical Spine Flashcards
What is mechanical back pain?
Recurrent relapsing back pain with no neurological symptoms
Give some causes of mechanical back pain
Obesity Poor posture Lack of physical activity Depression Prolapse Spondylosis
How is mechanical back pain treated?
Analgesia
Physiotherapy
What part of the disc is affected in an acute disc tear?
Outer annulus fibrosis
What commonly causes an acute disc tear?
Lifting a heavy weight
What is the main symptom of an acute disc tear?
Severe back pain worse on coughing
How is an acute disc tear treated?
Analgesia
Physiotherapy
What occurs in sciatica?
The nucleosis pulposis impinges on an exiting nerve root
What are the symptoms of sciatica?
Dermatomal pain
Altered sensation
Reduced power
What occurs in bony nerve root entrapment?
OA of facet joints causes osteophytes to impinge on exiting nerve roots
How is bony nerve root entrapment treated?
Surgical decompression (trimming osteophytes)
What causes spinal stenosis?
Spondylosis, bulging discs and osteophytosis causes less space in cauda equina
The pain in spinal stenosis is relieved by walking uphill/downhill?
Uphill
How is spinal stenosis treated?
Physiotherapy
Weight loss
Surgical decompression
What occurs in cauda equina syndrome?
Large central disc prolapse compresses all cauda equina nerve roots
What are the symptoms of cauda equina syndrome?
Bilateral leg pain
Saddle anaesthesia
Altered bowel/bladder habit
How is cauda equina syndrome investigated?
PR exam
MRI
What is the treatment of cauda equina syndrome?
Urgent disectomy
What are the red flag symptoms of back pain?
Back pain in patient <20 years
New back pain in patient >60 years
Constant severe pain worse at night
Systemic upset
What are the symptoms of osteoporotic crush fractures?
Acute pain
Kyphosis
What occurs in cervical spondylosis?
Spondylosis causes disc degeneration causing OA of facet joints
What are the symptoms of cervical spondylosis?
Slow onset stiffness and neck pain
What are the symptoms of a cervical disc prolapse?
Dermatomal shooting neuralgic pain
Loss of reflexes
What two conditions can lead to cervical spine instability?
Down’s syndrome
Rheumatoid arthritis
What occurs in cervical spine instability?
Atlanto-axial subluxation due to synovial joint destruction between atlas and dens
How is cervical spine instability treated?
Collar
Surgical fusion
