Spine examination
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Spine examination

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Spine examination Presentation Transcript

  • 1. SPINE examination
  • 2. History takingSYMPTOMS Pain (especially what inc. and what decrease ) Sciatica Stiffness Deformity Numbness or paraesthesia Urinary symptoms Other
  • 3. Examination of SpineSigns with the patient standingLook Skin Shape and postureFeel TendernessMove Flexion / Extension Rotation / Lateral flexion
  • 4. Examination of SpineSigns with patient lying on his back Straight leg raising test (sciatic stretch) Neurological examination of lower limbs Circulation in the limbs Rectal examinationSigns with patient lying face downwards Bony outlines Tenderness Sensations Power Femoral stretch test
  • 5. Cutaneous distribution ofnerve roots
  • 6. Muscle Power Testing (MRCScale0 Total paralysis1 Barely detectable contracture2 Not enough to act against gravity3 Strong enough to act against gravity4 Still stronger but less than normal5 Full power
  • 7. Cauda Equina Syndrome Large midline disc prolapse Compresses several nerve roots Sphincter disturbance Saddle anaesthesia Prompt surgical intervention
  • 8. Spinal DeformityDeformity may occur in either coronal or sagittal planeScoliosis - Lateral curvature of the spine Structural NonstructuralKyphosis - Sagittal plane deformity in the thoracic orthoracolumbar spine
  • 9. ScoliosisIdiopathic Scoliosis80% of all scoliosis Adolescent - age 10 or over Juvenile - age 4 to 9 Infantile - age 3 or under
  • 10. Kyphosis Postural (Round back) Compensatory Structural