Disclosures Depuy/Synthes Spine honoraria Physical Examination - - PowerPoint PPT Presentation

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Physical Examination of the Lumbar Spine

Disclosures

Depuy/Synthes Spine honoraria Stryker Spine consultant, honoraria, royalties Fellowship support: AOSpine, Nuvasive, Globus

4Assessment of Gait 4Inspection

– Posture – Sagittal/Coronal balance – Skin lesions

4Palpation

– Paraspinous muscles – Spinous Processes – Facets – SI joint – Ischial tuberosity – Greater trochanter (trochanteric bursitis) – Rib/Flank Hump (Adams Forward Bending test)

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ROM of the lumbar spine

4Flexion (forward Bending)-disc 4Extension-facets 4Extension with ipsilateral rotation Nerve, facets) 4ROM of hips

Neurologic testing

4Strength

– Hip flexors (L2) – Quadriceps (L2, L3, L4) – TA (L4, L5) – GS (S1) – EHL (L5) – FHL (S1) – Peroneals (S1) – Heel walking/Toe Raise – Trendelenberg test

Lower extremity reflex examination

4Knee Jerk-L3/4 4Ankle Jerk- S1 4Clonus 4Babinski

Lower extremity sensory examination

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Additional tests

4FABER (SI joints) 4Abdominal reflexes (Children, thoracic level neurologic disorders)