The spine Flashcards
What are the tests for back pain?
- bloods: CRP, ALP, calcium
- XR usually shows irrelevant things
- MRI if considering surgery or there are red flags
What are the red flags for back pain?
- neuro symptoms
- weight loss
- unwell
- spinal deformity
- immunocompromised
- previous cancer esp breast, bronchus or prostate
- thoracic pain/ pain worse at night
- age <20 or >50
What are the yellow flags for back pain?
- 2ndary legal gain
- job upset
- lifting at work
- obesity
- lower educational level
- low mood
- increased pain levels and disability
- “activity is harmful”
What is scoliosis?
lateral bending of the spine
- congenital: failure of segmentation of vertebrae
- neuromuscular: neuropathic or myopathic
What determines if scoliosis needs surgery?
- likelihood for curve progression
- cosmetics
- breathing difficulties
- care for disease associated
What is a kyphosis?
curve causing chin to touch chest
What is spondylolysis?
stress fracture of isthmus of vertebral arch
What is spondylolisthesis?
vertebrae slips eg spine off sacrum
What are the two emergencies for back pain?
- cauda equina syndrome
- fracture with deteriorating neurology
What are the main microbes for spinal infection?
- S.aureus
- S.epidermidis
- TB if abroad
What is spondylosis?
loss of water content so less cushioning and increased pressure on the facet joints
treat with physio and analgesia
What are the features of an acute disc tear?
- annulus fibrosis
- lifting heavy object
- worse of coughing
- physio and analgesia to treat
What is bony nerve root entrapment treated with?
trimming of osteophytes
What are the features of cervical disc prolapse?
- can lead to nerve root entrapment
- shooting pain
- loss of reflexes
- MRI (false positives)
What are the normal curves of the spine?
- cervical lordosis
- thoracic kyphosis
- lumbar lordosis
