Spine (Ther Ex Ch. 14-16) Flashcards
spondyLOLysis
LOL: Lumbar Out of Line
- Slipped vertebrae
Centralization vs Peripheralization
Peripheralization: symptoms are experienced farther down the legs or arms.
Centralization: symptoms recede back up the extremities or become localized in the back.
Laminectomy
HNP nerve root involvement
Spondylolisthesis interventions
Disk protrusion presentation
- Pain, muscle guarding
- Flexed posture, deviation away from the symptomatic side
- Neurological symptoms in dermatome and myotome of affected nerve roots
- Limited nerve mobility
- Increased/peripheralization of symptoms with sitting, prolonged flexed posture, sit-to-stand, coughing, straining, and repeated forward-bending tests.
Herniation
Displacement of disk material beyond normal limits.
Protrusion
Displaced disk material all the way to the edge, only held in by outer layers of annulus and ligaments.
Extrusion
Nuclear material leaking past ligaments and disk layers.
Sequestration
Free floating fragments of disk material.
Vertebral compression Fx
Types of disk lesions
Ankylosing spondylitis
Rheumatic disease characterized by chronic inflammation of the ligaments in lumbar and spinal areas.
- Gradual loss of motion and general stiffness
- Starts in SI and lumbar and works its way up
- Wake up early with pain, stiffness, and difficulty standing up straight
- Anterior longitudinal ligament fused to lumbar bodies
- “Bamboo spine”
Scheuermann’s Disease
- Weakening of the vertebral endplates that causes a crack and breakdown in weight-bearing ability of the vertebrael
- Typically T10-L2
Effects of flexion vs extension bias on disk pressure
Extension bias: Flexion puts pressure on anterior disk and squishes all of the fluid posteriorly. Extension spreads things out more evenly and reduces symptoms, unless there is also lateral deviation that needs to be addressed first.
Flexion bias: Extension puts pressure on facets and spinous processes and posterior disk. Flexion takes pressure off facet joints and reduces symptoms (??).
