Spinal conditions Flashcards
Spinal or intervertebral stenosis - etiology
narrowing of spinal canal or intervertebral forament coupled with hypertrophy of the spinal lamina and ligamentum flavum or facets
Spinal or intervertebral stenosis - results in
vascular and/or neural compromise
Spinal or intervertebral stenosis - s/s
Bilateral pain and paresthesia in back, buttock, thigh, calves and feet
Pain dec with flex, inc with ext
Pain inc with walking
Pain relieved with rest
Spinal or intervertebral stenosis - clinical tests
bicycle (van Gelderen’s test) will help identify and differentiate it from intermittent claudication
Spinal or intervertebral stenosis - PT traction
C spine positioned at 15 of flex to provide optimum opening of intervertebral foramina
Spinal or intervertebral stenosis - PT traction - contraindications include
joint hypermobility pregnancy RA down syndrome or any other systemic disease that impacts ligamentous laxity
Disc conditions - internal disc disruption - most commmon where
lumbar
Disc condition - internal disc disruption - s/s
constant deep, achy pain, and inc with mvmnt
No objective neuro findings but pt may have referred pain in LE
Posterolateral bulge/herniation - most common observed disc disorder of ____ spine due to
Lumbar
Post disc is narrower in height than anterior
Post longitudinal lig is not as strong and only centrally located in lumbar spine
Post lamellae of annulus are thinner
Posterolateral bulge/herniation - results from
overstretching and/or tearing of annular rings, vertebral endplate and/or ligamentous structures from high compressive forces or rep. microtrauma
Posterolateral bulge/herniation - results in
loss of strength
radicular pain
paresthesia
inability to perform ADLs
Posterolateral bulge/herniation - PT intervetion
Positional gapping for 10 minutes to inc space within region of space occupying lesion
Traction
Posterolateral bulge/herniation - PT intervention - positional gapping - if left posterolateral lumbar herniation is present - have pt
sidelying on R side with pillow under R trunk to accentuate R sidebending
Flex both hips and knees
Rotate trunk to left (or pelvis to R)
Central posterior bulge/herniation - more commonly observed where
cervical spine but can be seen in lumbar
Central posterior bulge/herniation - results in
loss of strength radicular pain paresthesia inability to perform ADLs possible compression of spinal cord - CNS s/s (hyperreflexia, pos babinski)