KIN 191A Advanced Assessment of  Lower Extremity Injuries THE THORACIC AND LUMBAR SPINE INJURIES
INTRODUCTION <ul><li>Erector spinae (paraspinal) muscle strain </li></ul><ul><li>Facet joint sprains/dysfunction </li></ul...
Erector Spinae Strains <ul><li>Easily the most common lumbar spine injury </li></ul><ul><li>Commonly, a history of heavy o...
Facet Joint Injuries <ul><li>Dislocation/subluxation </li></ul><ul><ul><li>“ Locking” of segment/s (hypomobility) </li></u...
Intervertebral Disc Injuries <ul><li>“ Bulging” or herniated disc is extrusion of nucleus pulposus through weakened area o...
Intervertebral Disc Injuries <ul><li>Condition typically associated with radiating neuro symptoms (dermatomes/myotomes) </...
Sciatica <ul><li>General term for any cause of inflammation and/or irritation of “sciatic” nerve </li></ul><ul><li>Similar...
Spondylopathies <ul><li>Most common in hyperextension activities </li></ul><ul><li>Most common at L4-L5 or L5-S1 </li></ul...
“ Scottie Dog”
Kin191 A.Ch.10.Lumbar.Thoracic.Injuries
Kin191 A.Ch.10.Lumbar.Thoracic.Injuries
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Kin191 A.Ch.10.Lumbar.Thoracic.Injuries

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Kin191 A.Ch.10.Lumbar.Thoracic.Injuries

  1. 1. KIN 191A Advanced Assessment of Lower Extremity Injuries THE THORACIC AND LUMBAR SPINE INJURIES
  2. 2. INTRODUCTION <ul><li>Erector spinae (paraspinal) muscle strain </li></ul><ul><li>Facet joint sprains/dysfunction </li></ul><ul><li>Intervertebral disc injuries </li></ul><ul><li>Sciatica </li></ul><ul><li>Spondylopathies </li></ul><ul><ul><li>Spondylolysis </li></ul></ul><ul><ul><li>Spondylolisthesis </li></ul></ul>
  3. 3. Erector Spinae Strains <ul><li>Easily the most common lumbar spine injury </li></ul><ul><li>Commonly, a history of heavy or repetitive lifting and complaining of aching pain centralized to the lower back </li></ul><ul><li>Pain with trunk motions (especially flex/ext), typically no neurological symptoms </li></ul>
  4. 4. Facet Joint Injuries <ul><li>Dislocation/subluxation </li></ul><ul><ul><li>“ Locking” of segment/s (hypomobility) </li></ul></ul><ul><ul><li>Often associated with a specific movement pattern </li></ul></ul><ul><li>Facet joint syndrome </li></ul><ul><ul><li>Repetitive stress from movement and/or loading </li></ul></ul><ul><ul><li>Usually no neuro symptoms unless inflammation impinges upon nerve roots </li></ul></ul><ul><li>Degeneration </li></ul><ul><ul><li>Degenerative changes may cause impingement on nerve roots and resultant radicular symptoms </li></ul></ul><ul><ul><li>Often presents with hypomobility of unknown origin </li></ul></ul>
  5. 5. Intervertebral Disc Injuries <ul><li>“ Bulging” or herniated disc is extrusion of nucleus pulposus through weakened area of annulus fibrosus with resultant impingement on nerve root typically at level below disc bulge </li></ul><ul><li>Often, annulus weakened by accumulative repetitive stresses and one event then causes final failure to contain nucleus </li></ul>
  6. 6. Intervertebral Disc Injuries <ul><li>Condition typically associated with radiating neuro symptoms (dermatomes/myotomes) </li></ul><ul><li>Often present with lateral shift away from impacted side to alleviate nerve root compression </li></ul><ul><li>Changes in body position (sitting to standing, etc.) change loads on discs and often exacerbate symptoms </li></ul>
  7. 7. Sciatica <ul><li>General term for any cause of inflammation and/or irritation of “sciatic” nerve </li></ul><ul><li>Similar symptoms to nerve root compression but originate at peripheral nerve level instead of spinal level (sensory/motor function) </li></ul><ul><li>Multiple potential causes – all encompassing term when specific pathology is difficult to identify </li></ul>
  8. 8. Spondylopathies <ul><li>Most common in hyperextension activities </li></ul><ul><li>Most common at L4-L5 or L5-S1 </li></ul><ul><li>Spondylolysis </li></ul><ul><ul><li>Pars interarticularis defect – “collared” Scotty dog </li></ul></ul><ul><li>Spondylolisthesis </li></ul><ul><ul><li>Bilateral pars defect with anterior listhesis (slippage) of one vertebrae on segment below – decapitated Scotty dog </li></ul></ul><ul><ul><li>Severity determined by amount of anterior displacement </li></ul></ul><ul><ul><li>Single leg stance test may assist in assessment </li></ul></ul><ul><ul><li>May have significant neuro sx with severe displacement </li></ul></ul>
  9. 9. “ Scottie Dog”

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