Spinal stenosis, claudication and cauda equina syndrome. Flashcards
Spinal stenosis?
Congenital narrowing of spinal canal w/ degenerative changes. Resulting impingement on nerves.
What can cause this narrowing?
herniated disc, hypertrophied facet joints, spondylosis, thickening of spinal ligaments, osteophytosis
Which part of the spine loses space?
Cauda equina
TRUE or FALSE: Claudication is a stymptom of spinal stenosis?
TRUE
Clinical features of SS?
- Progressive leg and back pain w/ standing and walking , relieved by sitting
- Stoop / sit / lean forward to relieve symptoms. STOOP = LATESIGN.
- “heavy” or “tired” legs
VASCULAR OR SPINAL claudication is relieved by flexion?
SPINAL. Flexion creates more space in cauda equina and relieves spinal stenosis.
Vascular is relieved by standing.
TRUE or FALSE: Cycling and uphill walking is difficult for those with spinal claudication?
FALSE. Difficult for those w Vascular claudication, not bad for those with Spinal.
What will an XR show for SS?
Degenerative changes
What investigation shows compression of neural elements and soft tissue?
MRI
Conservative SS management?
NSAIDS and analagesia
Surgical management?
laminectomy with root decompression
What is Cauda Equina Syndrome?
Compression of all of cauda equina nerve roots by large central disc prolapse causing loss of bladder and bowel control. Requires EMERGENCY SURGICAL INTERVENTION.
Symptoms and signs?
◊ bilateral leg pain,
◊ paraesthesiae or numbness & “saddle anaesthesia”
◊ urinary retention (common) or urinary incontinance (rarer)
Faecal incontinence & constipation
Is a PR exam always done for those with suspected Cauda equina?
YES
What investigation is carried out to determine level of prolapse?
URGENT MRI
