Lumbar spine Flashcards
What is Fryette’s 1st Law?
In neutral SB and rotation are OPPOSITE
What is Fryette’s 2nd Law?
In flexion or extension; SB and Rotation are SAME
What is Fryette’s 3rd law?
Movement in 1 plane decreases movement in other planes
What is type 1 lumbar dysfunction?
In neutral, many segments (NSR)
Adaptive: repetitive movement, imbalances, tightness
Corrected in both flexion and extension
What is type 2 lumbar dysfunction?
Either likes flexion (FRS) or extension (ERS)
ERS= corrects in extension (sphinx)
FRS= corrects in flexion (child’s pose)
How do you determine if a facet is open or closed?
You look at the sidebend if SB is R then R facet closed
What are some risk factors of low back pain?
Low educational status, stress, anxiety, depression, job dissatisfaction, low levels of social support in workplace
What can trigger acute LBP?
Physical factors and/or psychosocial factors
What does the American College of radiology recommend regarding LBP?
No imaging for first 6 weeks with LBP unless red flags are present:
recent substantial trauma or milder trauma in those over 50
Weight loss or fever with no known cause, immunosuppression
a previous cancer diagnosis, iv drug use, or osteoporosis
Being over 70 years old
Focal neurological deficit with progressive or disabling symptoms
What are the lumbar pathology pain regions?
Back
Buttock
Hip
Thigh
Leg
Foot
What are some signs of Lumbar spine pathologies?
LBP
Radiate in buttock, groin, leg, below knee
+/- neuro deficits reported
Pain with prolonged sitting or standing
+/- pain with sneezing
Relieved with rest
What is stenosis?
narrowing of vertebral space (better in flexion)
What is spondylosis (degenerative disc disease)?
begins in 20s overall OA and stenosis. General term for age related wear tear of the bones, cartilage, ligaments and disc of the spine
What is spondylolisis?
no displacement of pars interarticularis. Stress fx or complete fx of pars interarticularis
What is spondilolisthesis?
anterior translation of vertebral body relative to the other, and secondary to an abnormality of the pars interarticularis
90% at L5/S1, excessive lordosis, postural ache, mm spasm, tight psoas and hamstrings
What is ankylosing spondylitis?
inflammatory disorder of spine (synovial lining), morning stiffness, pain with exercise, leading to decrease vertebral movement (fusion)
What are some biomechanical restrictions?
ERS, FRS, NSR, neuromuscular control issues
What is radicular pain?
Evoked from inflamed or lesioned dorsal root or its ganglion (disc herniation most common cause)
What is radiculopathy?
impairs the conduction down a spinal nerve or its root, affecting sensory changes, motor fibers and possible reflexes
radicular pain can occur without radiculopathy
What are common complaints of facet joint syndrome?
Pain off to the side
May or may not have radicular symptoms (will terminate above knee), often radiating to thigh or groin
Pain inc with hyperextension, rotation and lateral bending and walking uphill
exacerbated when waking up or sitting for long periods (stiffness)
What is Lumbar spine stenosis and what are its common S/S?
progressive narrowing of central or lateral spinal canal, causing compression of neurovascular structures
S/S:
Midline back pain
radiculopathy (motor weakness, parasthesia)
Central: often bilat symptoms
Lateral: often lat symptoms
Ease discomfort: trunk flexion, sitting, lying
Aggravate: standing, lumbar extension
What increases the risk of disc degeneration?
diabetes
How can spondylolisthesis affect load sharing?
increased shearing forces
higher sacral slope and pelvic tilt (ant pelvic tilt and hyperlordosis)
increased pressure on discs, facet joints leading to degeneration
Muscle spasm of ES to protect
How do postural muscles tend to respond to injury?
with tightness in the form of spams or adaptive shortening
