Lumbar Spine Assessment

Question 1

Observation Posterior Aspect

Answer 1

• Posture (is it comfortable or are they in an “antalgic” position?)
• Ear levels, Shoulder heights, hip crests
• Bony and soft tissue contours
• Spinal alignment (lateral curves)
• Muscle bulk/atrophy
• Scapulae inferior angles (in line with T7 SP)
• Weight-bearing, foot position, foot pronation
• Pelvic points, knee creases, malleoli
• Skin

Question 2

Observation Lateral Aspect

Answer 2

• Spinal alignment (lordosis/kyphosis)
• Pelvic tilt and head carriage
• Knee position
• Increased lordosis: shortened LES and iliopsoas, weak abdominals and
glute max (pelvic-crossed syndrome); spondylolisthesis
• Decreased lordosis (flat back): Lx spinal stenosis, lateral stenosis (adaptive
posterior pelvic tilt with shortened hamstrings and weak hip flexor muscles,
to take pressure of nerve tissue)
• Sway back (reversed lordosis): thoracic kyphosis and posterior pelvic tilt
(get stretched anterior hip ligaments, LES and hip flexors; hip
hyperextension, and posterior vertebrae compression)

Question 3

Observation anterior aspect

Answer 3

• Head position
• Shoulder and arm carriage
• ASIS levels
• Leg position
• Foot position
• Skin etc

Question 4

Screen

Answer 4

ALWAYS SCREEN THE ADJACENT REGIONS
1. Thoracic screen (standing or seated Tx sidebending and rotation)
2. Hip screen (FABER or SQUAT)
3. Pelvis: assess pelvic points (do this supine and prone)
4. Screen Lumbar:
• Standing flexion test
• Seated flexion

Question 5

Active ROM: Lumbar

Answer 5

(do this standing)

1. Flexion
2. Extension
3. Sidebending
4. Rotation

Question 6

Passive ROM: Lumbar

Answer 6

(seated or sidelying)

1. Flexion
2. Extension
3. Sidebending
4. Rotation (Can be done prone)

Question 7

Active resisted ROM: Lumbar

Answer 7

Do this sidelying after passive testing. Get patient to push legs into you/away from you
• Flexion
• Extension
• Sidebending
• Rotation

Question 8

Accessory ROM: Lumbar

Answer 8

• Springing of lumbar spine in prone

Question 9

Palpation: Lumbar

Answer 9

• Quadratus Lumborum
• Multifidus
• Rotatores
• Erector spinae
• Rectus abdominus
• Transversus abdominus
• Internal and external obliques
• Psoas major
• Diaphragm
• Gluteals
• Hamstrings
• Lat dorsi