Lumbar spine examination

 

Lumbar spine examination

Standing (gait)

  • High steppage (foot drop)
  • Half-shut knife

Look

(inspection)

Feel

(palpation)

Move

Measure / special tests

  1. Skin (scar – sinus)
  2. Subcutaneous (swelling)
  3. Muscle (wasting – spasm)
  4. Bone (deformity)
  • from beck scoliosis
  • from side lumber lordidsos – dorsal kyphosis
(gentle and rapid)

  • Temperature
  • Tenderness
  • Erector spinae muscle
  • Tender segment
Active (1st)

  • Forward flexion5cm from the ground
  • Extension10-30˚ (support the patient)
  • Lateral flexion30˚ or touching knees
  • Rotation while sitting

Passive

Against resistance

Full range vs. limited range

Painful vs. painless

Supine

  1. Straight leg raising (crossed straight raising)
  2. Sciatic stretch test
  3. Neurological examination
    1. Sensation (dermatomes)
    2. Power (myotomes)
    3. Reflexes (kneeL2,3&4 – ankleS1)

Prone

  1. Femoral stretch test
  2. Tender segment

Examination of joint above and joint below

Examination of sensory and motor innervations

Complete comprehensive examination of Dermatomes, Myotomes and Reflexes

Exclude CAUDA EQUINE lesion

    1. incontinence
    2. tone of sphincter and sensation of saddle area

Examination of peripheral circulation

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Dermatomes.. Myotomes..