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THER EX 2: LQ > lecture 3: exercising after back sx and SI joint movements > Flashcards

lecture 3: exercising after back sx and SI joint movements Flashcards

1
Q

what is the main post op complications after back sx

A

local/systemic infection

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2
Q

what does PEACE and LOVE and when do u do it

A

Protection
Elevation
Avoid anti inflammation
Compression
Education
immediately after a injury

Load
Optimism
Vascularisation
Exercise
after the first days have passed

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3
Q

when do u usually want to load a ligament graft

A

around 6 weeks

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4
Q

when is the maximum protection phase for post op and what is it characterized by , time frame and things to consider

A

immediately after sx
characterized by tissue inflammation and pain
time frame : days to 6 weeks
things to consider
- possible immunization/ WBing stu’s
- bracing
- light loading

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5
Q

when is the moderate protection phase for post op , time frame and things to consider and what AROM do u return to

A

intermediate phase of healing , decreased tissue inflammation and pain allows for more mobility

time frame: 4-12 weeks

things to consider:  Restore normal arthrokinematics
 Gradually increase strength
 Improve neuromuscular control and stability

full , pain free AROM

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6
Q

what is the minimum protection phase for post op , what is the time frame and what are things to consider

A

little to no protection of sx tissues requires

time frame: 6wk to 12 months

Things to consider:
 Restore functional strength
 Consider sport/activity specific training
 Be specific in patient education

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7
Q

what is an absolute indication for sx

A

cauda equina syndrome

acute loss of function

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8
Q

what are post op precautions after lumbar spine sx

A

BLT’s
- No Bending
 No Lifting (over 10 pounds)
 No Twisting

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9
Q

extension instanteous axis of rotation comes with aging and the lumbar spine.. what is decreased and what is increased

A

decreased segmental control from the disc

increased stress on the facets and disc

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10
Q

side bendinginstanteous axis of rotation is from agin and the lumbar spine … what 2 things are increased

A
  • increased shearing and increased facet chondral load
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11
Q

what is a major stabilizer of the spine and is key for appropriate mobility and helps create coupled motions

A

intervertebral disc

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12
Q

what is it called when they remove a small amount og vertebral disc

A

microdiscectomy

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13
Q

what is a fusion

A

bones used to fuse the vertebrae together

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14
Q

what is often resected in a laminectomy

A

ligamentum flavum

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15
Q

after a laminectomy when can a patient start using a stationary bike

A

not until 3 weeks

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16
Q

what is a decompression without fusion called

A

miscrodiscectomy

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17
Q

what is detached during a microdiscectomy

A

detach the lateral attachments of the flavum ligament from the lamina

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18
Q

what is a medial facetotomy compared to a lateral facetotomy

A

if they remove part of the superior facet for medial

if they cant get it with medial may also take some of the inferior facet for a lateral

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19
Q

if a pateint has microdiscectomy when can they use a stationary bike

A

not until 6 weeks

20
Q

if a patient has a microdiscectomy when can they start spine ROM

A

6-8 weeks post op

21
Q

if a patient had a lumbar fusion when can they ride a stationary nike

A

> 6 weeks

22
Q

a posterior lumbar interbody fusion procedure gives posterior access thru whar 3 things

A
  • bilateral mm strip dissection
  • laminotomy
    -dura is retracted
23
Q

what is a Transforaminal Lumbar
Interbody Fusion (TLIF) ?

A

AKA posterolateral

unilateral laminectomy and inferior facetectomy

24
Q

the Anterior Lumbar Interbody
Fusion (ALIF) allows what

A

adequate access to the
entire ventral surface of the disc

25
Q

what is adjacent segment degeneration

A

when the adjacent segment becomes symptomatic causing pain or numbness

26
Q

what can a spinal sx lead to

A

increased forces and compression on IVD

27
Q

what is decompression with motion preservation

A

disc replacement

28
Q

what is disc replacements contraindicated for

A

hypertrophic facet joints
translational deformity (spondylolisthesis)
in segmental autofusion (ankylosing spondylitis)

29
Q

t/f: disc replacement is intended to stabilize the spinal column

A

false it is not intended to

30
Q

what is the post surgical management stage of recovery for 6 weeks max protection , 6 weeks moderate protection and 12 weeks progression

A

6 week max: heavy on manual therapy not a lot of sensory/nm control

6 weeks mod: 50/50 on manual therapy and sensory/neuromotor control

12 weeks: heavy on sensory/ neuromotor contrl

31
Q

what are 6 considerations for post surgical management for the back

A
  1. Disc hydration/dehydration
  2. Changing positions every 15-30 minutes
  3. Avoiding stretching and rotation of the lumbar spine
  4. Avoiding prone/flat sleeping
  5. Think about healing times
32
Q

what are 3 ways to rehydrate a disc

A

sit in chair with something behind back in a little extension

laying supine with legs elevated on something

laying on side with pillow in between legs

33
Q

all motions at the sacrum at SIJ are …

A

very small

34
Q

all motions in SIJ (rotatory or translatory) as result of LE motions are ___ dimensional

A

3

35
Q

what is sacral nutation

A

flexion at the sacrum

36
Q

which ligaments become taut during sacral nutation

A

sacrospinous and sacrotuberous ligament

37
Q

when is there sacral nutation

A

during
- stnading or landing side
- lordosis positions in standing or sitting
-occurs with spinal extension
- occurs with both innominates rotating posteriorly

38
Q

what is sacral counternutation

A

extension of the sacrum

39
Q

what ligament is taut during sacral counternutation

A

posterior sacroiliac ligament/long dorsal lig

40
Q

there is SIJ counternutation during what 2 thins and what way does this move the pelvic floor and when does it become an issue

A

occurs with anterior rotation of both innominates and with spinal flexion (decrease in lumbar lordosis)

this will move the pelvic floor anteriorly

becomes an issues when the lumbar spine flexes and the sacrum doesn’t move

41
Q

when does anterior rotation of the innominate occur

A

with hip extension

42
Q

posterior rotation of the innominates occur w what movement

A

hip flexion and SLS w gait (this is during closed chain)

43
Q

when does inflate and outflare of the innominates occur

A

inflate occurs when hip IR
outflare occurs when hip ER

44
Q

what happens at the ASIS and PSIS during anterior rotation

A

ASIS goes down and PSIS goes up

45
Q

what happens at the ASIS and PSIS during posterior rotation

A

ASIS goes up and PSIS goes down

46
Q

If a pateint has a anterior innominates and u want to give them an exercise what kind would u prescribe

A

i would give them an exercise that bring them into hip flexion which would lead to a posterior rotation and turns on their extensors

THER EX 2: LQ (4 decks)

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