Lumbopelvic Flashcards
spondylosis
age related degeneration
spondylolysis
defect in the pars interarticularis of the vertebra
spondylolithesis
forward displacement of one vertebra on another
retrolisthesis
backward displacement of one vertebra on another
peripheralization
pain is being referred distally toward or into a limb
centrilization
pain is moving toward the spine or source
mechanical low back pain
general term for back pain that does not refer distally
L1-5 oriented in…
25 degrees from sagittal plane
L1-5 have most motion in? least?
most motion in sagittal plane and resists rotation
where does the most rotation occur in the lumbar spine?
L5-S1
transitional spine
increased likelihood of mechanical instability
how much of the compressive load do the facets do
20%
sacral orientation
post to ant, inclined ant/inf 40 degrees
L5-S1 shear forces resisted by…
disc, ZAJ, ZAJ capsule, ALL, iliolumbar ligaments
lumbar lordosis
40-50 degrees
main job of lumbar discs
resist compression and tensionr
radial expansion
dissipation of forces by the disc in a circumferential fashion
what motion puts a lot of stress on the discs
combined flexion and rotation/twisting
ALL
thick ligament that resists anterior migration of the disc and resist lumbar extension
PLL
resists posterior migration of the disc centrally but provides little support in lateral recess
how many degrees of lumbar flexion
45-55 degrees
how much does the foramen open during lumbar flexion
up to 19% increase
intradiscal pressure laying down
25 kg
intradiscal pressure side lying
75 kg
intradiscal pressure standing
100 kg
intradiscal pressure standing leaning forward
150 kg
intradiscal pressure bending over to pick something up
220 kg
intradiscal pressure sitting in a chair
140 kg
intradiscal pressure sitting and bending over
185 kg
intradiscal pressure sitting and picking something up from the ground
275 kg
lumbar extension
15-25 degrees
what does the pelvis do in lumbar extension
anterior pelvic tilt
what happens to the foramen in with lumbar extension
11% decrease
what part of the spine has most pain in sagittal plane movements
disc
lumbar sidebending
20 degrees to each side
sidebending R causes the disc…
nucleus moves L
annulus bulges R
lumbar rotation
5-7 degrees each way
what causes the most pain in the facet joints
3D motions
type 1 classification for spondylolisthesis
dysplastic/congenital
translation is secondary to an abnormal neural arch
Fryette’s law type 2
ipsilateral coupling- sidebending and rotation occur in the same direction, occurs while in flexion
Fyette’s Laws type 1
contralateral coupling- sidebending and rotation occur in opposite directions, likely occurs in extension and neutral lordosis
type 2 classification for spondylolisthesis
isthmic: translation is secondary to a lesion involving the pars articularis
type 3 classification for spondylolisthesis
degenerative- result of chronic instability and intersegmental degenerative changes
type 4 classification for spondylolisthesis
post-traumatic: fracture in a region other than the pars leading to slippage
type 5 classification for spondylolisthesis
pathological: diffuse or local disease compromising the usual structural integrity that prevents slippage
type 6 classification for spondylolisthesis
iatrogenic: relating to illness caused by medical examination or treatment
lumbopelvic degrees of flexion to touch toes
45 deg lumbar flexion
60 deg hip flexion
lumbarization
movement between S1-2, almost like an extra lumbar vertebra
sacralization
fusion of L5-S1, one less lumbar vertebrae
iliosacral motion
movement of ilium on fixed sacrum
sacroiliac motion
movement of sacrum on fixed ilium
