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Orthopedics Prof Kwan > Spine > Flashcards

Spine Flashcards

1
Q

What is gibbus?

A

Acute angular deformity of the spine

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2
Q

Define Scoliosis

A

Lateral deviation of the spine in the coronal plane

OR

Lateral curvature of the spine >10 degrees of Cobb angle with rotation

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3
Q

List 2 types of spinal infection
1. Acute
2. Chronic

A

Acute -> Pyogenic Spondylodiscitis
Chronic -> Tuberculous spondylodiscitis

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4
Q

Differentiate between pyogenic spondylodiscitis and tuberculous spondylodiscitis

A
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5
Q

List the stages of degenerative spine disease

A

Stage 1 -> Annular tear and internal disc disruption
Stage 2 -> Prolapse disc
Stage 3 -> Spondylosis
Stage 4 -> Spondylolisthesis

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6
Q

Define Spondylosis

A
  • Spondylosis is the degeneration of vertebra/disc/facet joint with age
  • Bone spurs (osteophytes) formed may encroach upon intervertebral foramina or spinal canal causing pressure on nerve roots or spinal cord
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7
Q

State the differential diagnosis of spurs

A

A -> Osteophytes (Degenerative joint disease)
B -> Marginal Syndesmophytes (Ankylosing spondylitis)
C -> Non-marginal syndesmophytes (DISH)

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8
Q

Define Spondylolisthesis

A

Anterior displacement of vertebra or the vertebral column in relation to vertebra below

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9
Q

Name the classification of spondylolisthesis

A

Wiltse-Newman-Mcnab Classification

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10
Q

Name the scale used for classification of the degree of spondylolisthesis

A

Meyerding’s Scale
Amount of anterior displacement = x/y x 100%

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11
Q

Define Spondylolysis

A

Defect in pars intercularis with no movement of vertebral bodies

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12
Q

What can be seen in the Oblique X-ray of spondylolysis?

A

Scotty dog = Pars

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13
Q

Common primary sites of spine metastasis

A
  1. Lungs
  2. Breast
  3. Prostate
  4. Kidney
  5. Thyroid
  6. GI Tract
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14
Q

Describe the management of spine metastasis

A

Harrington Classification

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15
Q

Name the important lines in cervical radiograph

A

Line 1: Anterior vertebral body
Line 2: Posterior vertebral body
Line 3: Posterior facet joint
Line 4: Spinolaminar line
Line 5: Tip of spinous processes

Prevertebral soft tissue shadow (2cm at C6, 6mm at C2)

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16
Q

What is Steel’s Rule in a cervical spine

A
17
Q

Name and describe the grading system for spinal cord injury

A

Frankel Classification

18
Q

What are the red flags in back pain?

A
  • The very young (< 20 Y)
  • The very old (> 60 Y)
  • Presence of night pain and rest pain
  • Pain in the thoracic spine
  • Change in character of pain
  • Presence of constitutional symptoms such as loss of weight/appetite
  • Presence of neurological signs and symptoms such as UMN lesion or cauda equina syndrome
19
Q

How to differentiate spinal vs vascular claudication?

A
20
Q

Neurological findings for cervical and lumbar PID

A
21
Q

Define Cervical Spondylotic Myelopathy (CSM)

A

Compression of cervical spinal cord due to degenerative disease leading to cord dysfunction

22
Q

List the signs of CSM

A
  1. UMN signs -> Increased reflexes, tone, babinski positive, clonus
  2. Romberg sign positive
  3. Difficulty in toe to heel walk
  4. Lhermitte’s sign positive
  5. Other cervical myelopathic sign (Hoffman’s sign, Positive scapular humeral reflex, Finger escape sign, Grip and release test, Positive reverse supinator reflex)
23
Q

State the indication for surgery in a case of CSM

A
  1. Progressive neurological deterioration
  2. Functional impairment (JOA score < 13)
24
Q

Name the criteria used to diagnose ankylosing spondylitis

A
  1. Low back pain and stiffness for > 3 months and not relieved by rest
  2. Pain and stiffness in the thoracic region
  3. Limited motion in lumbar spine
  4. Limited chest expansion
  5. History of evidence of iritis or its sequelae
25
Q

What is the evidence in X-ray that supports the diagnosis of ankylosing spondylosis?

A

Bilateral sacroiliac changes

  • X-ray of BAMBOO SPINE
  • X-ray of SACROILITIS
26
Q

Diagnostic criteria of ankylosing spondylitis based on New York Criteria 1984

A

Definite radiograph sacroiliitis and one of the following:
1. History of inflammatory back pain
2. Limited motion of the lumbar spine in sagittal and frontal
3. Limited chest expansion related to standard values for age and sex

Orthopedics Prof Kwan (5 decks)

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