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Epidural abscess This condition is often a surgical emergency . The majority of cases occur within the thoracic spine. Without treatment, neurological deficit, including paralysis, may develop. Epidural abscess This condition is often a surgical emergency . Th...

Facet joint injections For patients with facet joint arthropathy , x-ray-guided local anaesthetic and steroid injections may be both diagnostic and therapeutic for 4–6 weeks. Longer term relief may be obtained by facet joint rhizolysis. This percutaneous proce...

Foraminal epidural steroid injections For patients with radiculopathy due to a prolapsed inter- vertebral disc or lateral recess stenosis, a targeted foraminal epidural injection of local anaesthetic and steroid may provide important diagnostic information an...

GLOBAL ISSUES IN SPINE SURGERY It is important that the information presented in this chapter, which is widely used throughout the world for teaching and training, outlines the very best evidence-based treatment that - is available for surgical conditions. The...

INFECTIONS OF THE SPINE Pyogenic infections Pyogenic vertebral osteomyelitis is primarily a lesion of the disc and its osseous margins. The most common method by which an organism spreads to the spine is via the haematogenous route. The disc is nearly always ...

INFLAMMATORY SPONDYLOARTHROPATHY Rheumatoid arthritis Disease-modifying anti-rheumatic drugs (DMARDs) are a class of drugs indicated for the treatment of rheumatoid arthritis. Conventional medications have been used such as methotrexate, leflunomide, hydroxyc...

INFLAMMATORY SPONDYLOARTHROPATHY Rheumatoid arthritis Disease-modifying anti-rheumatic drugs (DMARDs) are a class of drugs indicated for the treatment of rheumatoid arthritis. Conventional medications have been used such as methotrexate, leflunomide, hydroxyc...

INVESTIGATIONS The most common diagnostic imaging tests used to evaluate spinal disorders include plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), CT myelography and isotope bone scanning. These investigations are extremely sensit...

Idiopathic scoliosis Idiopathic scoliosis accounts for 70% of presentations. It can be classified into early onset (before 8 years of age) ( Figure 37.8 ) and late onset (after 8 years of age; typical adolescent idiopathic scoliosis). The distinction is impo...

Intradural tumours These are rare. They may be intramedullary (within the substance of the spinal cord) or extramedullary (outside the cord). Most are extramedullary and benign; the commonest are meningiomas and neurofibromas. Meningiomas are usually benign and...

Introduction No content extracted automatically.

Learning objectives To learn: The salient features relating to the history and examination • of the spine The investigations commonly used in the /f_i eld of spinal • disorders Learning objectives To learn: The salient features relating to the history and exam...

Lumbar disc herniation Symptomatic lumbar disc herniation occurs during the lifetime in approximately 2–4% of the population. Risk factors include family history , male gender, age (30–50 years), heavy lifting or twisting, stressful occupation, lower income a...

METABOLIC BONE DISEASES AFFECTING THE SPINE Osteoporosis Patients with osteoporosis may present with pain following minimal trauma, loss of height and exaggerated thoracic kyphosis. Medications used to prevent and treat osteoporosis include calcium, vitamin D...

METABOLIC BONE DISEASES AFFECTING THE SPINE Osteoporosis Patients with osteoporosis may present with pain following minimal trauma, loss of height and exaggerated thoracic kyphosis. Medications used to prevent and treat osteoporosis include calcium, vitamin D...

Magnetic resonance imaging This allows detailed visualisation of the spinal cord, thecal sac, epidural space, intervertebral discs, nerve roots, paraspinal soft tissues and bone marrow . It is contraindicated for patients with certain pacemakers and coronary ...

Neuromuscular scoliosis This may be due to neuropathic disorders, such as cerebral palsy , spinocerebellar degeneration, syringomyelia, tetraplegia ( Figure 37.9 ), spinal muscular atrophy and poliomyelitis, or myopathic disorders, such as Duchenne muscular dy...

Non-spinal causes of back pain Pain may arise from the spine, but non-spinal causes of pain must also be considered ( Table 37.6 ) . ) - Non-spinal causes of back pain Pain may arise from the spine, but non-spinal causes of pain must also be considered ( Tab...