Spine Flashcards
describe an acute disc tear
an acute tear in the outer annulus fibrosis of an intervertebral disc
what makes discogenic back pain sore( tear in spinal disk)
coughing
because this increases disc pressure
how long can symptoms of an acute disc tear take to settle
2-3 months
how do you treat acute disc tear?
analgesia
physiotherapy
what can cause bony nerve root entrapment leading to sciatica?
OA of facet joints can result in osetophytes impinging on exciting nerve roots
surgical decompression, with trimming of osteophytes can be used in certain candidates
what does this describe?-
the cauda equina of lumbar spine has less space due to bulging discs , bulging ligamentum flavum and osteophytosis
spinal stenosis
what is one of the main symptoms of spinal stenosis?
claudication (pain in legs on walking)
how does spine claudication differ to vascular claudication?
the claudication distance is not consistent
burning pain instead of cramping
pain is less walking up hill (spine flexion creates more space for cauda equina)
pedal pulses are preserved
treatment for spinal stenosis
conservative first- weight loss, physio
surgery- decompression to increase space
what is cauda equina syndrome?
when a very large central disc prolapse compresses all nerve roots of cauda equina
SURGICAL EMERGENCY!! prolonged compression can cause permanent nerve damage requiring colostomy and urinary diversion and urgent discectomy way
what is this?
bilateral leg pain paraesthesiae numbness and "SADDLE ANAESTHESIA!!" altered urinary function-typically retention faecal incontinence and constipation
cauda equina syndrome
investigations for cauda equina syndrome?
rectal examination
MRI!!- to determine level of prolapse
name some red flags for spine problems
back pain in younger patient 60
nature of pain-constant, worse at night, severe
systemic upset
name 2 symptoms of an osteoporotic crush fracture
acute pain
increase kyphosis
treatment for osteoporotic crush fracture?
usually conservative
ballon vertebroplasty
