Post Back Surgery & SIJ

Question 1

pre-op ___ leads to poor outcomes post-op

Answer 1

swelling

Question 2

when is PEACE used vs LOVE?

Answer 2

PEACE - immediately after
LOVE - subsequent

Question 3

what does PEACE stand for?

Answer 3

Protect
Elevate
Avoid NSAIDs
Compression
Education

Question 4

what does LOVE stand for?

Answer 4

Load
Optimism
Vascularization
Exercise

Question 5

when is the maximum protective phase?

Answer 5

days to 6 weeks

Question 6

what is the max protection phase characterized by?

Answer 6

tissue inflammation and pain

Question 7

when is the moderate protective phase?

Answer 7

4/6 weeks - 12 weeks

Question 8

what is the number 1 goal of the mod phase?

Answer 8

improve NM control and stability

Question 9

when should post-op pt have full, pain-free AROM?

Answer 9

mod phase

Question 10

when is the minimum protective phase?

Answer 10

6/12 weeks - 12 months

Question 11

when can pt move on to strengthening exercises?

Answer 11

when pain and swelling subside

Question 12

what is an absolute indication for surgery?

Answer 12

cauda equina syndrome

Question 13

indications for surgery

Answer 13

acute loss of function (ex: foot drop)
failure of 3 months of conservative tx

Question 14

surgery is more successful for _____ symptoms or loss of _____

Answer 14

radicular
function
not pain alone
usually within 1st 24 weeks

Question 15

post-op precautions for spine

Answer 15

BLTs
NO bending, lifting (>10 lbs), or twisting

Question 16

extension axis dysfunction with age leads to increased stress on ____ & _____

Answer 16

facets and discs

Question 17

side bending axis dysfunction with age leads to increased _____ and ______

Answer 17

shearing
facet chondral load

Question 18

what to avoid with side bending axis dysfunction with age?

Answer 18

braces
global core activation

Question 19

which part of the spine is more important to stability?

Answer 19

posterior

Question 20

which mm activation is important post laminectomy?

Answer 20

multifidus

Question 21

which lig is retracted with laminectomy?

Answer 21

lig flav

Question 22

when can stationary bike be used post laminectomy?

Answer 22

3 weeks post

Question 23

which motion increases compression in the L spine and should be avoided?

Answer 23

rotation

Question 24

medial facetotomy

Answer 24

part of the superior facets of the inferior vertebrae is removed

Question 25

lateral facetotomy

Answer 25

part of the inferior facet of the superior vertebrae is removed done is medial can't be

Question 26

when can stationary bike be used post microdiscectomy?

Answer 26

6 weeks post

Question 27

when can stationary bike be used post L fusion?

Answer 27

>6 weeks post

Question 28

what may occur at spinal levels surrounding fusion?

Answer 28

hypermobility

Question 29

which spinal level tends to be most commonly hypermobile?

Answer 29

L4/L5

Question 30

which motion blocks L spine rotation?

Answer 30

hip flexion

Question 31

which fusion approach has less injury to lig flav?

Answer 31

transforaminal lumbar interbody fusion (TLIF)/posterolateral

Question 32

which fusion approach creates more scar tissue?

Answer 32

anterior lumbar interbody fusion (ALIF)

Question 33

adjacent segmental DEGENERATION

Answer 33

REGARLESS OF SYMPTOMS, radiographic change in IVD adjacent to the surgically treated spinal level

Question 34

adjacent segmental DISEASE

Answer 34

SYMPTOMATIC adjacent segments causing pain and numbness

Question 35

if IVD is the ONLY prob (not instability), what surgery is used?

Answer 35

disc replacement decompression with motion preservation

Question 36

when is disc replacement contraindicated?

Answer 36

hypertrophic facet joints translational deformity segmental autofusion (AS)

Question 37

post op rehab start with ___ and progresses to _____

Answer 37

mainly manual mainly sensory/NM control

Question 38

when does the disc dehydrate?

Answer 38

throughout the day change in position WB walking

Question 39

variability of movement at the SIJ are result of variable influence of the

Answer 39

pubic symphysis

Question 40

what is the main function of the SIJ?

Answer 40

transmit forces

Question 41

what is the main function of the L spine?

Answer 41

stability

Question 42

what lig of the SIJ provides the most stability?

Answer 42

interosseous lig

Question 43

which SIJ lig check nutation?

Answer 43

sacrospinous and sacrotuberous

Question 44

the L spine ____ during sacral nutation

Answer 44

extends

Question 45

the innominates rotate ____ during sacral nutation

Answer 45

posteriorly

Question 46

the L spine ____ during sacral counternutation

Answer 46

flexes

Question 47

the innominates rotate ____ during sacral counternutation

Answer 47

anteriorly

Question 48

which lig checks sacral counternutation?

Answer 48

long dorsal

Question 49

the pelvic floor moves _____ with counternution and ___ with nutation

Answer 49

nut - posterior counternut - anterior

Question 50

in open chain, the innominate moves ___ with hip extension

Answer 50

anterior

Question 51

in open chain, the innominate moves ___ with hip flexion

Answer 51

posterior

Question 52

in SLS, the innominate moves _____

Answer 52

posterior (bc closed chain hip extension)

Question 53

innominate upslip and downslip occurs when

Answer 53

ASIS and PSIS move together up or down

Question 54

if the leg is physically pulled, a ___ occurs of the innominate

Answer 54

downslip

Question 55

inflare of innominate occurs with hip ___

Answer 55

IR

Question 56

outflare of innominate occurs with hip __

Answer 56

ER

Question 57

to assess inflare/outflare compare ASIS to

Answer 57

navel