Spine Degeneration, Back Pain and Disc Prolapse

Question 1

What are the general causes of lower back pain?

Answer 1

Neurogenic 
Spondylogenic 
Viscerogenic 
Vascular 
Psychogenic

Question 2

What is the most common type of lower back pain?

Answer 2

Mechanical

Question 3

What is the management for mechanical lower back pain

Answer 3

Simple analgesia regularly
Avoid bed rest, keep active
Physiotherapy

Question 4

What composes the intervertebral disc?

Answer 4

Annulus fibrosus

Nucleus pulposes

Question 5

What is the difference between the annulus fibrosus and nucleus pulposes?

Answer 5

Annulus fibrosus is the tough outer layer

Nucleus pulposes is the gelatinous core

Question 6

What is the nucleus purposes comprised of?

Answer 6

Water
Collagen
Proteoglycans

Question 7

What happens to the intervertebral discs during the normal ageing process?

Answer 7

Decreased water content of discs
Disc space narrowing
Degenerative changes of facet joints
Changes on x-ray

Question 8

What is the treatment for nerve root pain?

Answer 8

Strong analgesia
Physiotherapy
Most will settle in 3 months

Question 9

What are the different types of disc problems?

Answer 9

Bulge
Protrusion
Herniation/extrusion
Sequestration

Question 10

What is caudal equina syndrome?

Answer 10

Compression of the caudal equina

Question 11

What is the main cause of caudal equina syndrome?

Answer 11

Central lumbar herniated disc

Question 12

What are the other causes of caudal equina syndrome?

Answer 12

Tumours 
Trauma 
Spinal stenosis 
Epidural abscess 
Iatrogenic

Question 13

What are the clinical features of caudal equina syndrome?

Answer 13

Bilateral buttock and leg pain
Varying dysaethesia and weakness 
Bowel or bladder dysfunction 
Saddle anaesthesia 
Loss of anal tone and anal reflex

Question 14

What are the investigations for caudal equina syndrome?

Answer 14

MRI
Lumbar CT
Myelogram

Question 15

What is the treatment for caudal equina syndrome?

Answer 15

Surgery

Question 16

What are the complications of caudal equina syndrome?

Answer 16

Abnormal urinary function
Motor and sensory deficits
Perianal paraesthesie
Persistent sexual dysfunction

Question 17

What is cervical and lumbar spondylosis?

Answer 17

Spinal arthritis causing degenerative change at facet joints and discs

Question 18

What is the treatment for cervical spondylosis?

Answer 18

Non operative

Question 19

What are the signs and symptoms of spinal claudication?

Answer 19

Usually bilateral
Sensory dysaesthesiae
Postural weakness (foot drop)
Takes several minutes to ease after walking
Worse walking down hills, better walking uphill or riding bicycle

Question 20

What are the different types of spinal stenosis?

Answer 20

Lateral recess stenosis
Central stenosis
Foraminal stenosis

Question 21

What is the treatment for lateral recess stenosis?

Answer 21

Non operative
Nerve root injection
Epidural injection
Surgery

Question 22

What is the treatment for central spinal stenosis?

Answer 22

Non operative
Epidural steroid injection
Surgery

Question 23

What is the treatment for foramina spinal stenosis?

Answer 23

Non operative
Nerve root injection
Epidural injection
Surgery

Question 24

What is spondyloysis?

Answer 24

Defect of pars interacticularis

Question 25

What is spondylolisthesis?

Answer 25

Anterior veteran translation (slippage) of cephalad vertebra (above) on caudad vertebra (below)

Question 26

What are the symptoms of spondylolysis?

Answer 26

Low back pain

Occasionally radicular symptoms

Question 27

What are the investigations for spondylolysis?

Answer 27

X-ray
CT
MRI
Bone scan

Question 28

What is the treatment for spondylolysis?

Answer 28

Non operative
Injection therapy
Surgery

Question 29

How is spondylolisthesis?

Answer 29

Radiographic

Aetiologic

Question 30

What are the aetiologic classifications for spondylolisthesis?

Answer 30

Congenital 
Isthmic 
Degenerative 
Traumatic 
Pathologic