Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

Uh Hi, everyone. Um sorry, you're running a couple of minutes late. We were just getting everything set up and we'll just wait maybe a minute or so. Um, for some other people to join, um and we will make a start very, very soon. We're not gonna wait too long. Um We are here though. Ok, so, ok, just gonna wait for a couple more people to join. Ok. Um So we'll make a start. Hello everyone. Thank you for joining us today. My name is Gabby and I'm the education lead at s this week. We're focusing on um, neurosurgery specifically the spine. Um, and we're really excited to have you all with us today. I am joined by Thomas, um who is going to guide you through the spine. Um, and he is 1/5 year medical student studying at Cambridge um to make the session as engaging as possible. We, we will be releasing polls um at the end, these are completely anonymous. So we encourage you to participate actively and if you have any questions in the session, please put them in the chat and we'll do our best to address them at the end of the session. We're going to share a feedback form. If you complete this, you will receive a certificate of attendance and exclusive discount codes to teach me surgery past the MRC S. Um Additionally, the session is being recorded, the recording and slides will be shared on our metal page in a couple of hours after the session. So please keep an eye out for that. We're also excited to share that an exclusive question bank and other resources will be available from our learning portal. So please check them out on our website. If you create a free membership account with us, you will automatically receive a discount code for 10% off medics, anatomy, flash cards, surgery, flash cards, and um a knowledge bundle. Um We also have an exciting opportunity to all our attendees. Two lucky people will win free access to the ki medic surgical flashcards and medics ay stations to enter. Please complete the Google form at the end of the session and enter the unique code that we'll provide. The more sessions you attend the higher your chances of winning. So please stay until the end. Um To get access to that. Finally, before we begin, we'd like to thank our partners, the Royal College of Surgeons in England Medics, the MDU more than skin deep metal, teach me surgery and pass the MRC. So without further ado I'll hand things over to Thomas. Perfect. Thank you so much. Um Can everyone hear me. Ok, I think, yeah, we can hear you. Perfect. So, yeah, uh, as I said, we're going to be touching on the spine today and we're going to sort of be covering the sort of key acute conditions that we see with the spine, um, and sort of going over the management, the investigations and the red flags you'd expect to see. So, um, as I said, they'll be sort of putting some stuff out, some questions out as we're going along as well. So if you feel free to respond in the chat, um, as we go, but yeah, thank you so much for joining, um, spending your Tuesday evening uh on a quick review of the spine. So, uh as we said, thank you to the several partners that sort of help these sessions run and we've mentioned before. So I won't go over them again, but there, there is a, um, there they are all all there. So, um, today we're covering the spine. Um, and we're gonna go over several things. So we're gonna quickly go over the anatomy of the spine. So everyone can have a recap on the general structure of the spine and then also the individual vertebrae. Er, and then we're going to go over CHD uh equina syndrome, spinal cord compression, um, spinal infections, and then spinal stenosis. So the structure of the spine, overview of the human vertebral column. So as we know the, the spine is very key for providing support, flexibility and, and protection for the spinal cord. Um and very basic sort of structures that, that is composed of 33 vertebra and this is categorized into five key regions. So the regions of the spine. So we have the, the cervical spine, um which is seven vertebrae, the thoracic spine, which is 12 vertebrae, the lumbar spine, which is five vertebrae and the sacral sacral and coccyx. So, the sacral spine being five fused vertebrae and the coccyx being um a four. And on the right, we can see the different functions of each of these regions which I imagine most of you guys would be familiar with, but essentially are supporting the head allowing movement and then connecting the rib cage for stability. The lumbar spine is key for sort of uh weight bearing and and providing that flexibility. The sacral spine is is there to connect the spine to the pelvis. And then the coccyx uh also known as the tail bone is uh sort of there for for balance reasons. So the vertebral structure, so each vertebra consists of a vertical body which is for weight bearing. Um and then a vertical arch which sort of allows protection of the spinal cord itself. Um And then with each of those, there's a spinous and transverse process and these are the key attachment points for muscles and ligaments. Um Intervertebral discs can be found between the vertebrae and these are essentially act as as key cushions and these compose of sort of two key components. So you have the er analyser fibrosis, which is a tough outer layer and then you have the nucleus propulsive, which is the gel like sensor um which is key for shock absorption. And then regarding the the overall structure, if we're looking at it from a sort of very broad point of view, we have several curves. So we have the cervical and lumbar lordosis, which are the inward curves. And then we have the thoracic and sacral um outward curves. And these are again key with the general functions of the spine, which is balance, posture and shock absorption. So spinal cords are nerves. So the spinal cord runs through the vertebral canal and transmits signals between the brain and body. Er and there are several nerve root exits between the vertebrae. And these are as you guys will know, control, uh help control movement and sensation, what can go wrong with the general spine structure. So, I'm sure condition you guys heard of before scoliosis, this is the abnormal sideways curvature that we see. Sometimes. Um the discs between the vertebrae can become herniated and can even rupture. We can also get osteoarthritis, uh arth arthritis of, of the discs and the bones sorry of the vertebrae and the discs themselves. Um And then we also get spinal stenosis, which is that narrowing of the spinal canal. But today, we're gonna be focusing on sort of the q um sort of conditions that we see um with the spine and what can go wrong with that structure we've discussed. So um yeah, this is just another summary, but essentially the spine is essential for movement, support and protection of the nervous system, proper posture, exercise and medical care is needed to maintain spine health. Perfect. So, starting with our first condition condition, quadra quadrina syndrome. So surgical emergency and I'm sure most of you guys would have heard of this before and it's always mentioned on wards. But can anyone in the chat or give me a description of of what they know about quadra Aquinas syndrome uh already at this stage, either that might be the symptoms that we see the urgency of the of the condition, any ideas. So I've just seen one person having a technical issue there. But um yeah, perfect. So as you, as we know, chro is a surgical emergency which is caused by the compression of the cord quina itself. If untreated, it can lead to very severe complications. So, paralysis is sort of the key one there and the peak onset is 40 to 50 years of age and approximately this occurs in four in 10,000 patients with lower back pain. Um So although it sort of doesn't happen that many people uh with lower back pain, as we all know when we're on the wards, we're always looking out for this when anyone comes in with back pain problems. So what is the cord quina itself? So it's a bundle of nerves located just below the spinal cord and it's formed by the nerve roots from L1 to S five. Uh has several functions including sensory and motor impulses to the lower limbs, has motor innervation to the anal sphincters and also parasympathetic control of the bladder. Um All of which are sort of related to the, the symptoms we see when, when the compression um occurs. So, Quine syndrome is compression of the Cordona and this can be due to several reasons. So, disc herniation um which normally occurs at L5 to S one or L4 to L5 trauma itself. So that can be fractures or dislocations, neoplasms. So these can be primary or metastatic tumors, infections. So, discitis or pots disease and and pots disease is just tuberculosis of the spine there. Um chronic spinal inflammation. So ankylosing spondylitis or things that we've done. So this might be from anesthesia complications or, or certain medications. So what are the red flag symptoms? So, as you guys will know when you're taking a back history, there are certain things we have to look out for. So,