Spine Trauma Flashcards
Lumbosacral disk herniation
___ (most common site)
L5–S1
Features of ___:
–LMN signs in affected nerve root (unilateral)
–Paresthesia of the affected dermatome
–Muscle weakness
–Areflexia or hyporeflexia
radiculopathy
peripheral nerve lesion
Scapular winging
[nerve levels] radiculopathy
C3–C4
↓ Biceps reflex
__ radiculopathy
C5 (main nerve root)
C6
↓ Triceps reflex
__ radiculopathy
C7
and C8
↓ Biceps reflex
↓ Brachioradialis reflex
__ radiculopathy
C6
and C5
↓ Achilles reflex
__ radiculopathy
S1 (main nerve root)
S2
↓ Patellar reflex
__ radiculopathy
L3
L4 (main nerve root)
Damage to or compression of the nerve fibers
L3–S5 located below L2
Cauda equina syndrome
Gradual ⭐ usually unilateral Lower back pain
LATE onset of urinary retention
Saddle anesthesia (genitals/inner thighs) 😨
Asymmetric paresis of the legs
areflexia or hyporeflexia
Erectile dysfunction
Decreased rectal tone
Muscle atrophy
Diagnosis?
Cauda equina syndrome
(Gradual → Cauda has gotta build up)
(LMN signs)
Sudden ⭐ bilateral lower back pain EARLY onset of bladder and fecal incontinence Perianal numbness 😱 Symmetric paresis of legs hyperreflexia +/- fasciculations Erectile dysfunction
Sensory dissociation
+Babinski
Diagnosis?
Conus medullaris syndrome
(Acute → Conus is on us)
(LMN + UMN signs)
Damage to or compression of the spinal cord segments T12–L2, which are situated at approximately the level of the L1 vertebra
Conus medullaris syndrome
Presents with (+/-) – Localized neck or back pain
– Bilateral paralysis below affected level
– Sphincter dysfunction (urinary or bowel urgency, retention, or incontinence)
– loss of sensation
– Hyperreflexia
– +Babinski sign
Diagnosis?
Spinal cord compression
(It’s why during trauma we palpate the neck and along the back asking if it hurts and why we ask them to squeeze their butt cheeks otherwise we insert a finger in their butthole 😬)
*Tx may include decompressive surgery (ex: for disk herniation) or IV steroids and radiation therapy (for malignant compression).
Congenital malformation (dysplasia or hypoplasia) of the lumbosacral joints in L5–S1
Degenerative disease: most commonly in the elderly at L4–L5
(vertebra, slips out of position)
Spondylolisthesis
Spawn–deh–low–lis–thesis
Presents with:
CHRONIC lumbar pain
worsens with activity (spine extension)
Spine Step-off sign (+/-) 🚩
Gait problems
Diagnosis?
Spondylolisthesis
*Asymptomatic (in majority of pts)