Lecture 4: Lumbar Spine

Question 1

1. Patient history

what to look for?

Answer 1

• look for ‘no pain when seated’ for lumbar spine stenosis -likelihood ratio of 6.6
• pain not relieved by lying down- back pain at night
• morning stiffness 1/3 hr
• weakness, numbs, tingling, and or/ burning is not especially for lumbar radiculopathy

Question 2

2. neurological Screening:
   what would you screen?
   What would you find for a radiculopathy?
   what would you find for lumbar spine stenosis?

Answer 2

• MMT and reduced reflexes are suggestive of radiculopathy especially at L3/L4 spinal levels
• sensation testing (vibration and pin prick) with changes in reflexes, muscle strength, and sensations are found in conduction with positive straight-leg raise, Lx radiculopathy very likely
• decreased sensation (vibration and pin prick), muscular weakness, reflex changes are each modestly helpful in identifying lumbar spine stenosis

Question 3

What is centralisation?

Answer 3

When you can centralise a pain pattern? Ie if its running down the arm and you move the person such that the pain centralises to a certain area- highly likely disc is involved.

Question 4

2 Stage Treadmill test

Answer 4

lots more to this lecture but refer to slide