spine radiculopathy

Question 1

what is the typical presentation of spine radiculopathy?

Answer 1

LMN symptoms for the muscles innervated by spinal root and sensory would be a dermatomal pattern ( numbness and shooting sharp pain

Question 2

define spine radiculopathy?

Answer 2

Results from nerve impingement/inflammation causing neurological symptoms in the areas that are supplied by the nerve roots

Question 3

what are the causes of spine radiculopathy?

Answer 3

herniated disc

Spinal stenosis

degenerative disc disease/ spondylosis

ligamentous hypertrophy

Spondylolisthesis

rarer= radiation, DM (caused by altered nerve blood flow), neoplastic disease, Lyme meningitis

Question 4

what is spinal stenosis and what are its clinical features

Answer 4

usually caused by osteoarthritis

may be thoughout of as spinal claudication-> symptoms are caused by lack of blood supply to cauda equina in restricted spinal canal

symptoms are relieved by sitting or bending forwards-> actions widen the spinal canal and improve circulation

Question 5

what is degenerative disc disease/ spondylosis and what are its clinical features?

Answer 5

most common cause of back pain

attributable to osteoarthritic degenerative changes-> leading to loss of height of vertebrae and displacement of posterior facet joints

pain= aching in nature worse in mornings and following activity

Question 6

what is spondylolisthesis and what are its clinical features?

Answer 6

-when a vertebra moves and rests on the vertebra below “SLIPPED DISC”

linear lucency in the pars interarticularis seen on Xray. It commonly occurs at the L5/S1 region then at the L4/L5 region

Displacement is usually anterior

Back pain is usually worse while standing. A ‘step’ deformity may be felt on palpating down the spine.

Question 7

what are the symptoms and signs of radiculopathy?

Answer 7

Lumbar or sacral radiculopathy – primary cause of sciatica

Pain/electrical sensations in arms or fingers or legs at level of compression

Dull reflexes

Dermatomal sensory disturbance – numbness, tingling, reduced pain and temperature sensation

LMN weakness and eventual muscle wasting

UMN signs below level of affected root suggest cord compression – spasticity, weakness, brisk reflexes and upgoing plantars

Position and vibration sense may be lost

Question 8

what are the appropriate investigations for spinal radiculopathy?

Answer 8

Full neurological exam

MRI

X-ray and MRI

EMG to test nerve function

Nerve conduction studies

(FBC, ESR, CRP, CSF cultures)