Spinal Pathologies

Question 1

Give some back pain red flags

Answer 1

Age <20 or >55
Recent history of trauma 
Constant pain with no relief on rest 
Thoracic pain
Previous malignancy 
Prolonged use of corticosteroids
Immunosuppression 
Systemically unwell 
Neurological symptoms- Loss of sensation in limbs, urinary or bowel incontinence, limb weakness
Structural deformity 
Fever

Question 2

What is scoliosis?

Answer 2

Spine is twisted in the lateral plane

Question 3

How can scoliosis be managed nonoperatively?

Answer 3

NSAIDs, physiotherapy, steroid injections, back brace

Question 4

How can scoliosis be managed operatively?

Answer 4

Laminectomy
Spinal fusion
Discectomy

Question 5

What is kyphosis?

Answer 5

Curvature of the spine so the cervical spine is rounded more than 45 degrees

Question 6

What is disc herniation?

Answer 6

The nucleus pulposus pushes out of the surrounding annulus fibrosus.

Question 7

Give 4 symptoms of disc herniation

Answer 7

Lower back pain 
Pain in lower extremities
Numbness
Tingling in legs 
Sciatic nerve pain 
Potential for cauda equina symptoms

Question 8

What is spinal stenosis?

Answer 8

Reduction of the central or lumbar spinal canal

Question 9

Give 4 causes of spinal stenosis

Answer 9

Facet osteophytes
Slipped vertebrae (spondylolisthesis) 
Herniated disc
Synovial facet cysts 
Hypertrophy of ligamentum flavum

Question 10

How may spinal stenosis present?

Answer 10

Back pain, Buttock pain, Claudication, Unilateral leg pain, Weakness, Bladder disturbances

Question 11

What is the Kemp sign when suspecting spinal stenosis?

Answer 11

Unilateral radicular pain made worse on extension of back