Specialty Focused Recordings: Spine-Pre Op Spine Workshop Sub 2Gb

Video Transcription

Video Summary

Tracy Anderson outlines how to evaluate patients with possible spine problems in outpatient and emergency settings. Begin with the history: symptom duration and progression, prior spine surgery, treatments tried, recent illness or surgery, medications, and what prompted a change in symptoms. Examine strength, sensation, reflexes, and gait, while remembering that many MRI abnormalities are common in people without symptoms and most uncomplicated back pain improves without surgery.<br /><br />Imaging should be guided by clinical findings. X-rays provide a basic view of alignment and fractures; CT is useful for bone and trauma; MRI is preferred for nerves, infection, tumors, and soft tissues. New weakness or other changing symptoms may warrant repeat imaging, even after a recent scan. Red flags include trauma, fever, severe unrelenting pain, progressive deficits, saddle anesthesia, and urinary retention. Chronic pain or stable numbness generally needs evaluation but not emergency intervention.<br /><br />In trauma, assess the mechanism, blood-thinning medications, and neurological changes, and prioritize life-threatening injuries. If imaging does not explain symptoms, look higher in the spine and consider non-spinal causes such as stroke or ALS. For persistent pain without a surgical target, acknowledge its impact and consider options such as physical therapy, acupuncture, or pain management.

Keywords

spine evaluation

neurological examination

MRI imaging

red flag symptoms

trauma assessment

back pain management

outpatient emergency settings