Spinal Stenosis and Disc Injuries Quiz

A disc bulge occurs when the outer layer of the intervertebral disc (annulus fibrosus) weakens and bulges outward. It is often asymptomatic, meaning it doesn't cause pain, and is due to the loss of elasticity in the annulus fibrosus fibers. It's not like a herniation where the disc actually pushes out.

A disc bulge is more common in individuals between 30 and 40 years old.

While younger discs are generally stronger, severe stress or trauma can lead to early disc deterioration and bulge formation.

Older discs tend to be more stable due to desiccation, a process where they dry out and lose water content. This can prevent them from bulging as easily.

Disc bulges often develop over time due to repetitive flexion and rotation movements. This chronic stress weakens the disc fibers and leads to bulging.

The narrowing of a space within the spine, often caused by degenerative changes like arthritis.

A condition characterized by pain and numbness in the limbs due to compression of nerves in the spinal canal.

The gradual wearing down of the cartilage and bones in the spine, contributing to spinal stenosis.

Positions that reduce pain and discomfort, such as staying upright or avoiding certain movements.

Rotatory adjustments at the level of the stenosis are not recommended as they can worsen the condition.

Most disc prolapses will fully resorb on their own, typically taking 3 weeks to see symptom reduction and 6-8 weeks for full resolution.

Even after symptoms resolve, a bulging disc may still be visible on an MRI due to a loss of elasticity in the annular fibers.

Surgery is typically not required for disc prolapse, as most cases resolve naturally.

Some patients may experience ongoing symptoms despite disc healing due to remaining disc bulge or nerve sheath issues.

If annular fibers have lost elasticity, surgery may be needed to remove them.

Treatment aims to reduce the inflammatory cycle by improving blood flow, biomechanics, and avoiding pain-inducing activities.

Avoid activities that exacerbate the inflammatory cycle and increase pain in extremities.

Understanding the natural history of disc prolapse helps manage expectations and guide treatment decisions.

Improving blood flow to the affected area can help with healing.

Proper biomechanics around the spine help reduce strain and promote healing.

A condition where the nerve root is compressed as it exits the spinal canal through the intervertebral foramen. This occurs due to degenerative changes in the spine, leading to narrowing of the space.

The narrowing of the space where the nerve root exits the spinal canal, often caused by degeneration and changes in the facet joints.

Lateral lumbar stenosis and foraminal stenosis are both types of nerve root compression that can be very similar in appearance.

Lateral lumbar stenosis typically affects only one side of the body, because the overgrowth of bone or tissue pinches a specific nerve root on that side.

Lateral lumbar stenosis can occur where the nerve root exits the spinal canal or within the canal itself. This can affect the specific nerve root involved.

Lateral lumbar stenosis is often associated with a specific spinal nerve and affects the region that nerve innervates.

Lateral lumbar stenosis is often caused by overgrowth of bone or tissue on the facet joints. These overgrowths compress the nerve root.

Lateral lumbar stenosis can develop gradually over years, but may be quicker if caused by trauma, congenital abnormalities, or other spinal issues.

A narrowing of the space within the lumbar spinal column, leading to compression of the spinal cord.

The condition typically starts affecting individuals over the age of 65.

Trauma, contact sports, and smoking can accelerate spinal degeneration and lead to Lumbar stenosis in younger individuals.

Patients may experience a gradual, intermittent, and widespread cramping pain in their legs or back.

Patients may also experience tingling or numbness in their legs.

If the nerve compression is severe, patients may report a burning or electric shock sensation in their legs.

Patients may have weak leg muscles, muscle wasting, and reduced reflexes.

The symptoms are relieved by opening the spinal canal (flexion, contralateral lateral flexion) and aggravated by closing it (extension, ipsilateral lateral flexion).

A condition where the cerebellum and brainstem are pushed downward through the foramen magnum (the opening at the base of the skull).

Pain, numbness, or tingling in the arms, hands, and/or shoulders, often with a 'shawl-like' distribution.

Muscle weakness and wasting, especially in the hands, which can progress to the forearms and shoulders.

An extension of the Arnold-Chiari malformation into the brainstem, affecting the swallowing and breathing centers.

Difficulty swallowing, slurred speech, facial weakness, and eye movement problems.

A condition involving compression of the cauda equina (the bundle of nerves at the end of the spinal cord).

Numbness and/or tingling in the saddle area (perineum) surrounding the anus and genitals.

Difficulty initiating and controlling urination, leading to urinary retention and overflow incontinence.

Loss of control over bowel movements, ranging from incontinence to constipation.

Sharp, shooting pain that travels down the leg, sometimes affecting only one side (unilateral) or both (bilateral).

Weakness in the legs, often accompanied by sensory deficits.

Reduced or absent reflexes in the legs.

A test to check for saddle anesthesia by asking if the patient can feel sensation when wiping themselves after a bowel movement.

Surgical decompression of the spinal cord or nerves affected by the Arnold-Chiari malformation or other neurological conditions.

A device inserted to divert excess cerebrospinal fluid from the brain, often used to treat hydrocephalus and Arnold-Chiari malformation.