Spinal Conditions Flashcards
What is degenerative disc disease?
Age related condition, intervetebral discs deteriorate
pain; achey, may be flare-ups
X-ray, MRI, CT
Describe spondylolisthesis
condition where a vertebra (usually lower) slips forward onto bone beneath it
May be asymptomatic, can be painful or have kyphosis
How do you diagnose spondylolisthesis?
Standing x-ray
May have CT/MRI to assess for compressed nerve
What is the treatment for spondylolisthesis?
Usually non-surgical
- rest
- NSAIDs
- physiotherapy
- corticosteroid injections
Surgical fixation of bone
Describe non-surgical scoliosis treatment in children
Monitoring; if young spine may straighten as they grow
Wearing a cast; babies and toddlers
Back brace; prevent getting worse, won’t fix the curve though
Describe surgical scoliosis treatment in children
Younger children (<10) can have rods inserted along side spine
If stopped growing; spinal fusion, straightens spine using hooks, rods, screws etc which are left in place permanently
Describe surgical options for scoliosis in adults
Laminectomy; section of vertebra removed to relieve pressure on a nerve
Discectomy; section of disc removed to relieve pressure on a nerve
Spinal fusion; two or more vertebrae joined together to straighten and strengthen spine
How is sciatica managed?
Conservatively
Generally gets better in 4-6 weeks
Describe cauda equina syndrome pathology
Severe compression of nerves in lower back
An emergency; could lead to permanent paralysis
Describe the symptoms of cauda equina syndrome
- Sciatica on both sides
- Weakness/numbness of both legs which is getting worse
- Numbness around/under genitals or anus
- difficulty starting to pee or controlling when you pee
- not noticing when you need to poo or not able to control it
What is the treatment for cauda equina syndrome?
Emergency laminectomy to relieve pressure
What investigations should you carry out for metastatic spinal cord compression?
MRI whole spine
NOT PLAIN RADIOGRAPHS
What treatment should patients with metastatic spinal cord compression be given?
Corticosteroids while planning treatment; dexamethasone 16mg loading dose and 16mg daily until treatment plan
Radiotherapy or surgery
Describe ankylosing spondylitis
Condition where spine and other areas become inflamed
Develops first in teens and young adults usually
What are symptoms of ankylosing spondylitis?
back pain/stiffness
swelling around joints in other parts of body
extreme tiredness
