John Petrizzo, PT, DPT, CSCS
Demographics Spinal pathology is seen across all demographics and age groups Affects people throughout their lives Number one reason for PT referral Highest cost to employers
Functions of the Spine Establishes our posture Provides an attachment site for many muscles Transmits forces Protects the spinal cord
Spinal Anatomy 33 Vertebrae (Approximately) 7 Cervical 12 Thoracic 5 Lumbar 5 Sacral (fused) 4 Coccygeal (fused)
Spinal Anatomy
Spinal Anatomy Cervical lordosis Thoracic kyphosis Lumbar lordosis Curves of the spine help us to absorb shock!
Spinal Anatomy: Ligaments
Spinal Anatomy: Intervertebral Disc
Posterior Musculature of the Spine
Posterior Musculature of the Spine
Anterior Musculature of the Spine
Anterior Musculature of the Spine
Pathologies: Spinal Stenosis Stenosis Diameter of intervertebral foramen is decreased Management: Relief with flexion
Pathologies: Spinal Stenosis
Pathologies: Scoliosis Scoliosis Lateral curvature
Pathologies: Spondylosis Spondylosis Essentially OA of the spine
Pathologies: Spondylosis
Pathologies: Spondylolysis and Spondylolisthesis Congenital weakness in pars interarticularis Associated with repeated spinal hyperextension Gymnastics, dance, etc. Characterized by LBP Relief with flexion and modified activity
Spondylolysis and Spondylolisthesis
Spondylolisthesis
Treatment: Stenosis, Spondylosis, Spondylolysis/listhesis https://www.youtube.com/watch?v=zYVGQwYfsKU https://www.youtube.com/watch?v=T1FrBPVCtgE https://www.youtube.com/watch?v=-9XwclhulSE
Herniated Disc Occurs with “fatigue failure” or traumatic rupture Difficult to heal Pain from increased pressure Disc can no longer withstand compressive forces as well
Herniated Disc
Treatment: Herniated Disc Controlled rest Educate on positions to avoid/lifting mechanics Flexion and rotation! Stability in area of herniation, mobility above and below! Postural re-education Goal is to have progressive centralization of symptoms!
Treatment: Herniated Disc https://www.youtube.com/watch?v=clfpWjqVP6U
Core Training Options for Back Pain https://www.youtube.com/watch?v=zEvy5CCvNLA
Remember! If any exercise or activity that you are doing increases your back pain or related symptoms, STOP!
Questions?
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