Special conditions affecting the spine

Question 1

How common is Padgets disease?

Answer 1

3% of people over 55 year in USA

Question 2

What is the cure for Padgets diseae?

Answer 2

The is no cure.

Question 3

What happens in Padgets disease?

Answer 3

A mosaic pattern weak bone structure resulting from reduced osteoclastic activity and secondary subsiding osteoblastic hyperactivity.
Painless bowing of long bone.
Backpain is a rule
Skullbone is affected.

Question 4

What malignacy can occur secondarily to Padgets disease?

Answer 4

Sarcoma from the osteoblasts.

Question 5

When is surgery indicated for Padgets disease?

Answer 5

• in case of sarcoma
• Severe kyphosis.
  But its associated to SEVERE bleeding and survival expectancy is 5.5 years with padgets and sarcoma.

Question 6

What is syringomyelia

Answer 6

Cystic ? of the spinal cord. Partial obstruction of the subarachnoid space.

Question 7

What is syringomyelia ssociated to?

Answer 7

70% to Chiari I malformation
10% basilar invagination

Question 8

How should syringomyelia be treated?

Answer 8

That is dependent on underlying cause

Question 9

What is syringomyelia syndrome?

Answer 9

• sensory loss - cape common to central cord syndrome
• Pain - dysesthetic pain often occur in the distribution of the sensory loss.
• LMN weakness - of hand/arm
• Charcots joints

Question 10

What needs to be ruled out in suspicion of syringomyelia syndrome?

Answer 10

Malignancy - cystic glioma

Question 11

What is NOT recomended for syringomyelia?

Answer 11

• Plugging obex
• Syringostomia
• cordectomy
• percutane ?

Question 12

WHat CAN be done in case of syringomyelia?

Answer 12

• Reestablished CSF flow - by posterior decompression of chiari
• subarach-subarach bypass shunt
• syrinx shunts - may function as critical stabilisation 10yrs for about 50%