Spinal red flags

Question 1

What is cauda equina syndrome?

What are the symptoms?

Answer 1

Compression of the lumbar plexus results in loss of function, can result in:

• bladder, bowel and sexual dysfunction
• altered sensation in perianal area

Question 2

What are the red flags relating to the back/spine? (8)

Answer 2

1. onset of pain at <20 or >60
2. non-mechanical pain (constant, not w/ movement)
3. history of cancer
4. history of steroids
5. systemic: malaise, fever, weight loss
6. structural deformity
7. loss of sensation (buttocks and perianum)
8. severe pain for >6 weeks

Question 3

Cervical spine X-rays are important in trauma patients, as they can pick up a fracture at C7/T1 (typical level of fracture). (T/F)

Answer 3

True

Question 4

Central Cord Syndrome tends to arise due to a hyperextension neck injury. It tends to result in dysfunction of legs, with arms functioning normally. (T/F)

Answer 4

False

Legs work fine, arms are worse

Question 5

Anterior Cord Syndrome results in the loss of motor function, pain and temperature sensation, deep touch, position and vibration.
The cause tends to be _____ or _______

Answer 5

Traumatic or vascular

-e.g. complication of AAA repair

Question 6

Ankylosing Spondylitis causes lumbar spine rigidity. When should it be supported with a collar to correct the kyphosis?
What investigation is essential?

Answer 6

Never

Support the spine in its natural position, if fractured

-Always get a CT to look for fracture!

Question 7

Cauda equina syndrome requires emergency surgical treatment (T/F)

Answer 7

True

-can result in persisting dysfunction of bowel/bladder

Question 8

Pain due to cerviacal spine spondylosis can radiate to _____ and the back of the ____

Answer 8

shoulders and back of the head