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Y2 MSK > Spine Conditions > Flashcards

Spine Conditions Flashcards

1
Q

Red flag symptoms are present with mechanical back pain. True/False?

A

False

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2
Q

What is meant by spondylosis?

A

Intervertebral discs lose water content with age, resulting in less cushioning

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3
Q

Where does acute spinal disc tear/extrusion occur (which part of the IV disc)?

A

Outer annulus fibrosis

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4
Q

What is characteristic of pain from acute IV disc tear?

A

Worse on coughing

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5
Q

Acute disc tears usually resolve by themselves. True/False?

A

True

Analgesia and 3 months of physio are main treatment

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6
Q

What is the main complication of disc tears? How is it managed?

A

Nucleus pulposis can herniate outwards and impinge on nerve root —> nerve root compression
Doesnt settle in 3 months = surgery (disectomy/ decompression)

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7
Q

Pain in sciatica follows what distribution?

A

Dermatomal distribution

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8
Q

What is meant by spinal stenosis? How is it managed?

A

Cauda equina has little space and nerve roots can become compressed/irritated by osteophytes
Surgical decompression and stabilisation

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9
Q

List contributing factors to spinal stenosis

A

Bulging IV discs
Bulging spinal ligaments
Osteophytosis

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10
Q

Claudication classically occurs with spinal stenosis. How does this differ from vascular claudication?

A 
Burning pain (rather than cramping)
Pain walking downhill
Pedal pulses normal
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11
Q

What is cauda equina syndrome?

A

Large central disc prolapse can compress all the lumbosacral nerve roots of the cauda equina

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12
Q

Cauda equina syndrome can be managed conservatively. True/False?

A

False

It is a surgical emergency!

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13
Q

List clinical features of cauda equina syndrome

A

Bilateral leg pain (LMN signs)
Saddle anaesthesiae/numbness
Altered bowel habit
Loss of anal tone

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14
Q

What examination is mandatory in cauda equina syndrome?

A

PR exam

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15
Q

What is the urgent treatment for cauda equina syndrome?

A

Urgent MRI to determine level of prolapse

Disectomy

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16
Q

List 4 red flag symptoms of spinal disease

A

Back pain in young patient (<20)
New back pain in old patient (>50)
Constant, severe pain, worse at night (non-mechanical pain)
Systemic upset
Saddle anaesthesia + bladder/bowel upset
Feeling unwell/ weight loss/ Hx of carcinoma
Severe pain > 6 weeks

17
Q

List clinical features of cervical nerve root compression

A

Shooting neuralgic pain in dermatomal patternWeakness/loss of reflexes

18
Q

Which nerve root is involved for C6/C7 disc nerve root compression?

A

C7 root (there is no C1 nerve root)

19
Q

Which nerve root is affected by C8/T1 disc nerve root compression?

A

C8 root

20
Q

What is the first-line investigation for back pain?

A

MRI

21
Q

Define sciatica

A

Buttock +/- leg pain in a dermatomal distribution accompanied by neurological disturbance

22
Q

Disc prolapse is a medical emergency. True/False?

A

False

Only if accompanied by cauda equina symptoms

23
Q

What is spondylolysis?

A

Defect in the pars interarticularis of the vertebra

24
Q

What is spondylolisthesis?

A

Forward slippage of one vertebra onto another

25
Q

In spondylosis, pain is worse on what movement of the spine?

A

Extension

SHOPPING TROLLEY SIGN

26
Q

What is the classical history for acute disc tear?

A

Happened when lifting a heavy object

27
Q

What sign on MRI is suggestive of discogenic back pain?

A

White annular tear

28
Q

What are the common clinical signs of spinal stenosis?

A

Limited walking
Stoop/sit/lean forward to relieve
Heavy/ tired legs

29
Q

What is the typical management of mechanical backache?

A

Short bed rest
Anti-inflammatory +/- muscle relaxant
Mobilise (exercise)

30
Q

In what situation, would you encounter a chance fracture?

A

Young patient, seatbelt injury

31
Q

What is ‘spinal shock’?

A

Loss of sensation and motor function post injury, which resolves in 24 hours

32
Q

What are the classical symptoms of spondylolisthesis?

A

Low back pain
Radiculopathy
Flat back (muscle spasm)
Waddling gait

Y2 MSK (30 decks)

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