Spinal Deformity and Red Flags

Question 1

how would you treat patients with low back pain, nerve root or mechanical back pain who have no red flags?

Answer 1

supportive advice and reassurance; stay active etc

Question 2

what ages are red flags for back pain?

Answer 2

<20 and > 60

Question 3

PMH in what types of cancer are red flags?

Answer 3

all

Question 4

is steroid use a red flag in a patient with back pain?

Answer 4

yes

Question 5

give an example of emergencies associated with back pain?

Answer 5

cauda equina syndrome

fracture with deteriorating neurology

Question 6

main symptoms of cauda equina?

Answer 6

bilateral sciatica

loss of bladder and bowel control

Question 7

what to do first if you suspect an emergency in someone with a back pathology?

Answer 7

immobilise
x-ray
neuro exam

Question 8

what vertebral levels indicate an accurate x ray?

Answer 8

C7/T1 - they must be shown

Question 9

treatment for cervical spine injury?

Answer 9

rigid collar

Question 10

treatment for thoracolumbar injury

Answer 10

rigid spine board

Question 11

most common vertebral bodies affected in a thoracolumbar injury?

Answer 11

T12/L1

Question 12

main priorities for a spinal patient in an emergency situation

Answer 12

RESUS - keep them oxidised and perfused

not moving them comes after

Question 13

give examples of things that can cause secondary cord damage

Answer 13

oedema
ischaemia
thrombosis of small vessels
venous obstruction

Question 14

is a 1 or A on ASIA spinal grading normal sensory and motor function or not?

Answer 14

complete motor and sensory loss

Question 15

would a patient with a huge spinal cord injury with saddle sparing be considered as having a complete or incomplete cord injury?

Answer 15

incomplete

Question 16

main cause of a central cord injury?

Answer 16

hyperextension

Question 17

is a central cord injury complete or incomplete?

Answer 17

incomplete

Question 18

clinical feature of a brown-sequard injury?

Answer 18

paralysis on ipsilateral side and hypaesthesia on contralateral side

Question 19

which spinal complication is common in vascular problems such as AAA?

Answer 19

anterior cord

Question 20

can infection and hypotension cause secondary cord damage?

Answer 20

yes

Question 21

how can children get kyphosis of the spine?

Answer 21

congenital

damage to growth plate causes premature fusion and cessation of growth

Question 22

how to treat an emergency patient with ankylosing spondylitis?

Answer 22

immobilise them in their natural kyphotic position, not straight up as this will cause damage
CT CT CT

Question 23

why is ankylosing spondylitis seen as an emergency when they have a fracture?

Answer 23

their bones arent rigid so are very susceptible to injury

Question 24

condition that commonly presents with pseudotumours?

Answer 24

ankylosing spondylitis