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Injuries to spinal cord and vetebral bodies Disc prolapse

Injuries to spinal cord and vetebral bodies Disc prolapse -...

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Injuries to spinal cord and vetebral bodies Disc prolapse In 20-40 year olds it is usually around L4/5 or L5/S1.Symptoms depend on severity of herniation. Most posterolateral. Pain in usually in the back and also the buttocks and leg (usually one) On examination: pain on SLR + dorsiflexion Management: surgery indicated if cauda equina syndrome, persistant pain (>2weeks), neurological deterioration or recurrent attacks. *Spinal stenosis (spinal claudication)* This is a narrowing of spinal canal usually due to osteoarthritis it often leads to pain on walking relieved by rest. Usually it is the cervical or lumbar spine affected. Management is conservative or surgical decompression. Spondylolisthesis This is a forward shift of spine, usually at L4/5. Laminae facet locking mechanism fails. It can lead to stress fractures and osteoarthritis of facet joints In children look for a protruding belly
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Unformatted text preview: • Adults often present with back pain On examination: • transverse loin creases • flat buttocks +/- scoliosis Management: • X-Ray. • Bed rest and support corset. • If leads to neurological signs may need spinal fusion to fix unstable segment. Scoliosis and kyphosis Scoliosis This is a lateral curvature of spine • Postural – secondary to condition outside of spine e.g. short leg/pelvic tilt. Disappears on sitting. • Structural – bony abnormality/vertebral rotation – fixed – does not disappear on sitting. Management: • supports if under 40 years old • surgery if over 40 years old. Kyphosis This is a dorsal curvature of spine • Postural – poor posture +/- pes planus • Structural – fixed -Osteoporosis, Ank Spondylitis etc. Management: • Postural training/surgical fixation....
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