Red Flags and Emergencies Flashcards
A history of what medication is a red flag sign for back pain
Steroids
What is the main red flag that is indicative of a serious underlying problem
Previous history of cancer (that can metastasise to bone)
What are the only 2 spinal emergencies
Cauda equina syndrome
Fracture with deteriorating neurology
Describe symptoms of Cauda Equina
Various urinary upsets are common
Painless retention with overflow
Most are atypical
What should be done for a suspected spinal fracture
Immobilise
Xray
Don’t forget other injuries
What is important to clearly see on a Cervical spine Xray
C7/T1 joint
Where is the most common place for a thoracolumbar injury
T12 or L1
What are secondary problems of cord damage
Cord swelling oedema ischaemia thrombosis of small vessels venous obstruction
Who is likely to sustain a central cord injury
An elderly patient who falls, with a hyperextension neck injury
What happens in a Brown - Squared cord injury
Paralysis on ipsilateral side
Hypaesthesia on contralateral side
Best prognosis
Traumatic and associated with fracture
What is anterior cord syndrome
Type of problem seen after a vascular insult (a complication of AAA repair)
Poor prognosis
Loss of pain and temperature
Loss of pain and temperature sense
What causes secondary cord damage
Hypotension Hypoxaemia stretching compression undue movement infection
what surgery is performed if necessary on a cervical spine fracture
Decompression and fusion and fixation
what surgery is performed if necessary on a thoracolumbar spine fracture
Decompression by anterior route
This is controversial
Stabilisation
When should spinal surgery be performed
Within 7-10 days (after the swelling has gone down and tissue perfusion has improved)
