Lumbar Spine Injuries

1
Lumbar Spine Injuries
2
Low Back Injuries

• Prevention
• correction of postural problems
• trunk general body flexibility
• proper back care
• lifting
• standing
• sleeping
• weight
• fitness

3
Strains and Sprains

• injury to muscles or ligaments
• mechanism
• twisting
• sudden extension against resistance
• chronic - faulty posture
• S S
• pain, spasm, limited motion,

4
Fractures

• Transverse Spinous Processes
• mechanism - direct blow or violent muscular
  contraction
• palpate spinous processes just lateral to them
• Compression Fx.
• Vertebral bodies
• causes by vertical (axial loading)
• L1 most common area
• Coccyx - falling on butt

5
Disk Problems

• herniated, bulging, protrusion
• degeneration of disk (annulus fibrosus) from
  repeated trauma or faulty posture
• protrusion of disk on nerve root
• S S
• constant pain in low back, numbness in legs or
  feet, weakness in legs or feet, radicular pain,
  Milgram Test, problems defecating, possible
  hyporeflexia, sensory deficit and/or muscle
  weakness

6
Disk Problems (cont.)

• Forward flexion of the trunk will produce
  significant pain increase in distal symptoms
• herniations
• protrusion
• prolapse
• extrusion
• sequestration

7
Spondylolysis

• A defect in the pars interarticularis
• causes chronic pain in the low back
• could have radiating pain in buttocks upper
  thighs
• congenital or stress fx. - caused by
  hyperextension rotation
• gymnasts football lineman

8
Spondylolisthesis

• slippage forward of one vertebrae on one below
• L4-L5, L5-S1 - most common
• 5 of those that have spondylolisis develop this
• tx. - conservative - strengthening
• 50 slippage or greater - surgery

9
Sciatica

• Irritation of sciatic nerve
• overuse - running
• trauma to buttocks
• herniated disk
• Piriformis Syndrome
• spasm or swelling of piriformis muscle
• Other Causes
• disk herniation, SI joint problems, spinal
  stenosis, nerve root inflammation

10
Sacroiliac Dysfunction

• SI joint is a relatively immobile joint
• Mechanisms
• Rotation of the ilium on the sacrum (if extreme)
  can cause the ilium to sublux on the sacrum
• Injury or degeneration of the pubic symphysis can
  cause SI pain
• Prolong stress on the SI joint by tight muscles
• S S pain over one or both of the SI joints,
  could radiate into buttocks, groin, and thigh