spinal cord diseases Flashcards
name some acute causes of spinal cord compression
trauma
prolapsed disc
infection - epidural abscess
tumours: haemorrhage or collapse
name some chronic causes of spinal cord compression
degenerative diseases : most commonly spinal canal stenosis
tumours
rheumatoid arthritis
what is the most common cause of non-traumatic spinal cord compression in adults
malignancy
name 3 primary cancers that commonly metastasise to the spine
breast, lung and prostate
what is the main risk factor for an epidural abscess
IV drug use
what are the most common levels for disc prolapse
L4-5 and L5-S1
describe the pain in spinal cord compression
severe - worse at night or lying flat
name some clinical signs of spinal cord compression due to an upper motor neuron lesion
spasticity, hyperreflexia, babinski’s sign
what is babinski’s sign
reflex response - NOT normal older than 2yrs
upward movement of the toes when the sole of the foot is stroked
name some clinical signs of spinal cord compression due to a lower motor lesion
flaccidity, hyporeflexia
what is brown-sequard syndrome
hemisection of the spinal cord
what is damaged in brown-sequard syndrome (3)
descending lateral corticospinal stracts
ascending dorsal column
ascending spinothalamic tracts
clinical presentation of brown-sequard syndrome
ipsilateral hemiplegia and loss of proprioception and vibration
contralateral loss of pain and temperature sensation
investigation for suspected spinal cord compression
MRI whole spine
what is sciatica
characteristic pain felt in lower back, bum and posterior and lower leg caused by compression of any of the 5 nerve roots that contribute to the sciatic nerves
nerve roots for the sciatic nerve
L4, L5, S1, 2 and 3
where does the sciatic nerve bifurcate and what does it become
popliteal fossa
tibial nerve and common peroneal (fibular) nerve
what is the most common cause of sciatica
intervertebral disc prolapse
name some risk factors for sciatica
obesity
smoking - disc degeneration risk
diabetes - neuropathy risk
occupation / heavy lifting
clinical presentation of sciatica
unilateral radiating back pain
sharp, shooting, burning
worsened by sitting, bending or lifting
numbness of affected leg
clinical sign that indicates sciatica and a positive result
lasegue’s sign: straight leg test
pain worsens with passive leg elevation >30 degrees
management of sciatica
physio
NSAIDs and analgesia
