Lumbar Spine

Question 1

Lumbar Spine Soft Palpation

Answer 1

anterior abdominal muscles
paraspinal muscles
 - iliocostalis
- longissimus
- spinalis

sciatic nerve

gluteus medius
gluteus maximus

hamstrings

• biceps femoris
• semitendinosus
• semimembranosus

Question 2

Lumbar Spine Bony Palpation

Answer 2

iliac crests
lumbar spinous processes

psis
scaral tubercles

Question 3

Straight Leg Raiser (SLR)

Answer 3

( + ) radiating pain and/or dull posterior thigh pain
( i ) sciatic radiculopathy or tight hamstrings
- positive between 35 and 70 = possible discovenic sciatic radiculopathy
- positive over 70 = tight hamstrings

Question 4

Bragard Sign

Answer 4

( + ) radiating pain in posterior thigh

( i ) sciatic radiculopathy

Question 5

Buckling Sign (Cipriano)

Answer 5

( + ) pain in posterior thigh with sudden knee flexion or buckle
( i ) sciatic radiculopathy

Question 6

Lasegue Test

Answer 6

( + ) reproduction of pain before 60 degrees

( i ) sciatica

Question 7

Milgram Test

Answer 7

( + ) inability to perform test and/or low back pain

( i ) weak abdominal muscles or space occupying lesion

Question 8

Hoover Sign

Answer 8

( + ) lack of counter pressure on the healthy side
( i ) lack of organic basis for paralysis (malingering/hysteria)
- with organic hemipalegia, patient will still exert downward pressure when attempting to raise the paralyzed leg

Question 9

Goldthwait Sign

Answer 9

( + ) localized pain, low back pain or pain radiating down the leg
( i ) lumbosacral or sacroiliac pathology
- pain occurying after lumbar spinouses move = possible lumbosacral problem
- pain occurring after lumbar spinouses move = possible sacroiliac problem

Question 10

Bowstring Sign

Answer 10

( + ) pain in lumbar region or radiculopathy

( i ) sciatic nerve root compression, this rules out tight hamstrings

Question 11

Valsalva Maneuver

Answer 11

( + ) radiating pain from the site of lesion, usually recreating the complaint in cervical or lumbar spine
( i ) space occupying lesion, possible disc pathology

Question 12

Bechterew Test

Answer 12

( + ) reproduction of radicular pain or inability to perform correctly due to tripod sign
( i ) sciatic radiculopathy

Question 13

Neri Bowing Test

Answer 13

( + ) pain accompanied by flexion of the knee on the affected side with possible body rotation away from affected side
( i ) positive for a variety of low back pathologies. Hamstring tension on the pelvis may trigger a response

Question 14

Lewin Standing Test

Answer 14

( + ) radiating pain down the leg causing sudden flexion of the knee or knees
( i ) gluteal, lumbosacral or sacroiliac pathologies

Question 15

Heel Walk

Answer 15

( + ) inability to perform test

i ) L4-L5 disc lesion (L5 nerve root

Question 16

Toe Walk

Answer 16

( + ) inability to perform test

i ) L5-S1 disc lesion (S1 nerve root

Question 17

Anterior Innominate Test

(Mazion’s Pelvic Maneuver/
Advancement Sign)

Answer 17

a. ( + ) radiating pain along sciatic nerve, either unilateral or bilateral
a. ( i ) sciatic neuralgia or radiculopathy
- - - - - - - - - - - - - - -
b. ( + ) low back pain (lumbar or pelvic region)
b. ( i ) anterior (rotational) displacement of ilium relative to the sacrum

Question 18

Ely Heel to Buttock Test

Answer 18

a. ( + ) inability to raise the thigh
a. ( i ) iliopsoas spasm
- - - - - - - - - - - -
b. ( + ) pain in anterior thigh
b. ( i ) inflammation of lumbar nerve roots
- - - - - - - - - - - -
c. ( + ) pain in lumbar region
c. ( i ) lumbar nerve rood adhesions