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Spine > Spine diseases/syndromes of the spine > Flashcards

Spine diseases/syndromes of the spine Flashcards

1
Q

degenerative causes of sensory symptoms in the cervical spine?

A
  • stenosis
  • disc herniation
  • cynovial cyst
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2
Q

extradural neoplasms in the cervical back?

A
  • metastases
  • primary bone-tumours
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3
Q

intramedullary neoplasms in the cervical spine?

A
  • Ependymoma
  • Astrocytoma
  • Hemangioblastoma
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4
Q

Characteristics of ependymoma on MRI?

A

Hypointensities correlating to hemosiderin above and below the tumor on T2W images.

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5
Q

Characteristics of intramedullary Astrocytomas?

A
  • longer than 6 vertebras
  • Cysts within the lesion
    *rarely hemorrhage at the margins
  • May have mixed enhancement pattern
    + Younger patients
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6
Q

Intradural, extramedullary neoplasms in the cervical spine

A
  • Meningioma
  • Schwannoma
  • Neurofibroma
  • Ganglioneuroma
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7
Q

most common cause of anterior cord syndrome

A

infarction/compression of the anterior spinal artery.

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8
Q

Presentation of anterior cord syndrome?

A
  • Paraplegia. (If above C7 = Quadriplegia)
  • Loss of pain and temperature sensation (spinothalamic tract)
    • Preserved 2 point discrimination, joint position sense, deep pressure sensation
      (posterior column functions)
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9
Q

When is it reasonable to consider surgery in anterior cord syndrome?

A
  • in cord compressions
  • In instability
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10
Q

What are signs of central cord syndrome?

A
  • Disproportionate greater motor deficits in the upper compared to the lower extremities.
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11
Q

WHat is burning hand syndrome?

A
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12
Q

Cause of central cord syndrome?

A

This is a watershed area and therefore sensistive. Usually due to hyperextension injuries in the presence of osteophytic spurs.

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13
Q

When is surgery applied for central cord syndromes?

A
  • In ongoing compression, usually in a non-emergency basis.
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14
Q

What are the entities running in the spinothalamic tract?

A

pain and temperature sense.

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15
Q

What is Brown Sequard syndrome?

A

?

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16
Q

What usually causes Brown Sequard syndrome?

A
  • penetrating trauma
  • radiating myelopathy
  • Cord compression (eg epidural HT)
  • cervical disc herniation
    (tumors, AVMs, cervical spondylosis, herniation)
17
Q

Clinical findings of Brown Sequard Syndrome

A
  1. Ipsilateral:
    *Motor paresis below lesion
    *Loss of posterior column function
  2. Contralateral:
    * Loss of pain and temperature sensation - 1-2 segments below injury

preserved light (crude) touch.

18
Q

What is “posterior cord syndrome”

A

?

19
Q

Clinical findings of “posterior cord syndrome”

A

mild paresis in UE and
PAIN and PARESTHESIA (often burning) in neck, upper arms and torso.

20
Q

How common is Brown Sequard syndrome?

A

?

21
Q

How common is central cord syndrome?

A

?

22
Q

How common is posterior cord syndrome?

A

?

23
Q

Which of the cord-syndromes may be surpassing?

A
  • central cord syndrome
    ? more?
24
Q

What is different from central/posterolateral disc herniation in Foraminal and extraforaminal lumbar disc herniations?

A
  • less common
  • compression of exiting nerve root at the index level
  • typically manifest with radiopathy and focal sensorimotor deficits.
25
Q

What structure might be compressed in foraminal/extraforaminal lumbar disc herniation?

A

Dorsal root ganglion

26
Q

Due to compression of the dorsal root ganglion, how might the pain appear ?

A

burning, dysthetic.

27
Q

What is spondylolisthesis?

A
28
Q

What three types of disc herniations are there?

A
  • protrusion
  • extrusion (a line of anulus = contained or uncontained= no anulus seen around the protrusion anymore)
  • sequestration
29
Q

Which are the most common locations of lumbar disc herniation?

A

Central and posteriolateral.

30
Q

What are the symptoms from central lumbar disc herniation?

A
  • cauda equina
  • nerve root compression:
    ‘radiculopathy
    *sensorimotor deficits
  • bowel/bladder issues
  • neurogenic claudicatio
  • lower back pain.
31
Q

Other names for posterolateral disc herniatin?

A
  • paracentral
  • subarticular
  • lateral recess herniation
32
Q

What nerve is usually affected in a posterolateral disc herniation?

A

The traversing nerve root at that level. Ex. herniation at L4-L5 often affect the L5 nerveroot that traverse the L4-L5 level and exits at the L5 level.

33
Q

If a posterolateral disc herniation is very large/wide, it might also compress another nerve. which?

A

The exiting nerve root in the foraminal zone.

34
Q

When should surgical resection be considered for a lumbar disc herniation?

A
  • significant neurological symtoms
  • Failed nonoperative treatment
35
Q

foraminal/extraforaminal/faar lateral L4-L5 herniation would cause a nerve compression…on what level?

A

L4 compression

Spine (17 decks)

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