Mr James AkinwunmiConsultant Neurosurgeon.

Hurstwood Park Neurological Centre.Spire Gatwick Park Hospital.

Protection. Muscular attachment. Mobility. Support (stability).

Disc prolapse. Spinal stenosis Radiculopathy Myelopathy Radiculomyelopathy. Instability. Tumours. Trauma.

Urinary incontinence.Altered bowel habits. Impotence.Spastic Gait.Muscular weakness.

- foot drop.

Change in urinary/bowel/erectile function.

Perianal numbness/incontinence.Constant unremitting backpain- ? tumour.

Muscle weakness/wasting.

Nerve pain – radiation down the limb.

Numbness.Paraesthesia.+ve nerve stretch test.Reduce/absent tendon reflex.Muscle wasting/weakness.

Radiculopathy. Neckpain. Numbness. Paraesthesia. Headaches.

Anterior cervical disc prolapse. Stenosis – degenerative changes.

Muscle wasting. Muscle weakness.

Wasting of deltoid muscle.

Difficulty abducting the shoulder.

Poor resistance to adduction the shoulder.

Biceps wasting. Weakness of

elbow flexion. Inability to lift

objects up.

Triceps wasting. Weakness in elbow

extension/wrist extension.

C8

Leg pain. Paraesthesia. Numbness. Muscle fasciculation.

Muscular wasting. Weakness. Changes in bladder/bowel habits.

Wasting of quadriceps. Difficulty in climbing stairs.

Can the patient stand and walk on their heels.

Can the patient stand and walk on tip-toes. Is there calf wasting.

Neurological deficits. Unremitting pain -chronic. Worsening on coughing. Nocturnal pain. Sensory level. Radicular Pain.

Case study

Mr AB

Aged 18

Playing cricket

Developed back pain, which did not resolve with conservative measure.

Patient also had nocturnal pain.

When to GP – advised conservative management.

Patient presented to the A/E (x3) with tingling in his feet.

Patient developed difficulty in walking and latter developed paralysis.

Case study

Mrs DARTA 8/52? Cervical #She had continues pain.Cervical muscular spasm.Could not tolerate, being without a collar.

Patient sent for physiotherapy.

Physiotherapist not happy so therefore sent for a Neurosurgical consultation.

THANK YOU