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Ther Ex 2 > Post Back Surgery & SIJ > Flashcards

Post Back Surgery & SIJ Flashcards

1
Q

pre-op ___ leads to poor outcomes post-op

A

swelling

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2
Q

when is PEACE used vs LOVE?

A

PEACE - immediately after
LOVE - subsequent

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3
Q

what does PEACE stand for?

A

Protect
Elevate
Avoid NSAIDs
Compression
Education

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4
Q

what does LOVE stand for?

A

Load
Optimism
Vascularization
Exercise

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5
Q

when is the maximum protective phase?

A

days to 6 weeks

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6
Q

what is the max protection phase characterized by?

A

tissue inflammation and pain

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7
Q

when is the moderate protective phase?

A

4/6 weeks - 12 weeks

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8
Q

what is the number 1 goal of the mod phase?

A

improve NM control and stability

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9
Q

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

A

mod phase

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10
Q

when is the minimum protective phase?

A

6/12 weeks - 12 months

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11
Q

when can pt move on to strengthening exercises?

A

when pain and swelling subside

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12
Q

what is an absolute indication for surgery?

A

cauda equina syndrome

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13
Q

indications for surgery

A

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

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14
Q

surgery is more successful for _____ symptoms or loss of _____

A

radicular
function
not pain alone
usually within 1st 24 weeks

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15
Q

post-op precautions for spine

A

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

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16
Q

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

A

facets and discs

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17
Q

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

A

shearing
facet chondral load

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18
Q

what to avoid with side bending axis dysfunction with age?

A

braces
global core activation

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19
Q

which part of the spine is more important to stability?

A

posterior

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20
Q

which mm activation is important post laminectomy?

A

multifidus

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21
Q

which lig is retracted with laminectomy?

A

lig flav

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22
Q

when can stationary bike be used post laminectomy?

A

3 weeks post

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23
Q

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

A

rotation

24
Q

medial facetotomy

A

part of the superior facets of the inferior vertebrae is removed

25
Q

lateral facetotomy

A

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

26
Q

when can stationary bike be used post microdiscectomy?

A

6 weeks post

27
Q

when can stationary bike be used post L fusion?

A

> 6 weeks post

28
Q

what may occur at spinal levels surrounding fusion?

A

hypermobility

29
Q

which spinal level tends to be most commonly hypermobile?

A

L4/L5

30
Q

which motion blocks L spine rotation?

A

hip flexion

31
Q

which fusion approach has less injury to lig flav?

A

transforaminal lumbar interbody fusion (TLIF)/posterolateral

32
Q

which fusion approach creates more scar tissue?

A

anterior lumbar interbody fusion (ALIF)

33
Q

adjacent segmental DEGENERATION

A

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

34
Q

adjacent segmental DISEASE

A

SYMPTOMATIC adjacent segments causing pain and numbness

35
Q

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

A

disc replacement
decompression with motion preservation

36
Q

when is disc replacement contraindicated?

A

hypertrophic facet joints
translational deformity
segmental autofusion (AS)

37
Q

post op rehab start with ___ and progresses to _____

A

mainly manual
mainly sensory/NM control

38
Q

when does the disc dehydrate?

A

throughout the day
change in position
WB
walking

39
Q

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

A

pubic symphysis

40
Q

what is the main function of the SIJ?

A

transmit forces

41
Q

what is the main function of the L spine?

A

stability

42
Q

what lig of the SIJ provides the most stability?

A

interosseous lig

43
Q

which SIJ lig check nutation?

A

sacrospinous and sacrotuberous

44
Q

the L spine ____ during sacral nutation

A

extends

45
Q

the innominates rotate ____ during sacral nutation

A

posteriorly

46
Q

the L spine ____ during sacral counternutation

A

flexes

47
Q

the innominates rotate ____ during sacral counternutation

A

anteriorly

48
Q

which lig checks sacral counternutation?

A

long dorsal

49
Q

the pelvic floor moves _____ with counternution and ___ with nutation

A

nut - posterior
counternut - anterior

50
Q

in open chain, the innominate moves ___ with hip extension

A

anterior

51
Q

in open chain, the innominate moves ___ with hip flexion

A

posterior

52
Q

in SLS, the innominate moves _____

A

posterior (bc closed chain hip extension)

53
Q

innominate upslip and downslip occurs when

A

ASIS and PSIS move together up or down

54
Q

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

A

downslip

55
Q

inflare of innominate occurs with hip ___

A

IR

56
Q

outflare of innominate occurs with hip __

A

ER

57
Q

to assess inflare/outflare compare ASIS to

A

navel

Ther Ex 2 (5 decks)

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