SPINE examination

History takingSYMPTOMSPain (especially what inc. and what

decrease )SciaticaStiffnessDeformityNumbness or paraesthesiaUrinary symptomsOther

Examination of Spine

Signs with the patient standingLook

Skin Shape and posture

Feel Tenderness

Move Flexion / Extension Rotation / Lateral flexion

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 examination

Signs with patient lying face downwards Bony outlines Tenderness Sensations Power Femoral stretch test

Cutaneous distribution of nerve roots

Muscle Power Testing (MRC Scale 0 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

Cauda Equina Syndrome

Large midline disc prolapseCompresses several nerve rootsSphincter disturbanceSaddle anaesthesiaPrompt surgical intervention

Spinal Deformity

Deformity may occur in either coronal or sagittal plane

Scoliosis - Lateral curvature of the spine Structural Nonstructural

Kyphosis - Sagittal plane deformity in the thoracic or thoracolumbar spine

Scoliosis

Idiopathic Scoliosis80% of all scoliosis

Adolescent - age 10 or overJuvenile - age 4 to 9Infantile - age 3 or under

Kyphosis

Postural (Round back)CompensatoryStructural