Spine Degeneration, Back Pain and Disc Prolapse Flashcards
(30 cards)
What are the general causes of lower back pain?
Neurogenic Spondylogenic Viscerogenic Vascular Psychogenic
What is the most common type of lower back pain?
Mechanical
What is the management for mechanical lower back pain
Simple analgesia regularly
Avoid bed rest, keep active
Physiotherapy
What composes the intervertebral disc?
Annulus fibrosus
Nucleus pulposes
What is the difference between the annulus fibrosus and nucleus pulposes?
Annulus fibrosus is the tough outer layer
Nucleus pulposes is the gelatinous core
What is the nucleus purposes comprised of?
Water
Collagen
Proteoglycans
What happens to the intervertebral discs during the normal ageing process?
Decreased water content of discs
Disc space narrowing
Degenerative changes of facet joints
Changes on x-ray
What is the treatment for nerve root pain?
Strong analgesia
Physiotherapy
Most will settle in 3 months
What are the different types of disc problems?
Bulge
Protrusion
Herniation/extrusion
Sequestration
What is caudal equina syndrome?
Compression of the caudal equina
What is the main cause of caudal equina syndrome?
Central lumbar herniated disc
What are the other causes of caudal equina syndrome?
Tumours Trauma Spinal stenosis Epidural abscess Iatrogenic
What are the clinical features of caudal equina syndrome?
Bilateral buttock and leg pain Varying dysaethesia and weakness Bowel or bladder dysfunction Saddle anaesthesia Loss of anal tone and anal reflex
What are the investigations for caudal equina syndrome?
MRI
Lumbar CT
Myelogram
What is the treatment for caudal equina syndrome?
Surgery
What are the complications of caudal equina syndrome?
Abnormal urinary function
Motor and sensory deficits
Perianal paraesthesie
Persistent sexual dysfunction
What is cervical and lumbar spondylosis?
Spinal arthritis causing degenerative change at facet joints and discs
What is the treatment for cervical spondylosis?
Non operative
What are the signs and symptoms of spinal claudication?
Usually bilateral
Sensory dysaesthesiae
Postural weakness (foot drop)
Takes several minutes to ease after walking
Worse walking down hills, better walking uphill or riding bicycle
What are the different types of spinal stenosis?
Lateral recess stenosis
Central stenosis
Foraminal stenosis
What is the treatment for lateral recess stenosis?
Non operative
Nerve root injection
Epidural injection
Surgery
What is the treatment for central spinal stenosis?
Non operative
Epidural steroid injection
Surgery
What is the treatment for foramina spinal stenosis?
Non operative
Nerve root injection
Epidural injection
Surgery
What is spondyloysis?
Defect of pars interacticularis
