Exam of the Lumbar Spine



- See:
      - PE of C-Spine:
      - Neuro Exam


- Inspection: (scoliosis, thoracic kyphosis, lumbar lordosis, zoster ect.)


- ROM:
    - extension: Phalen's test (lumbar stenosis)
    - flexion:
          - frequently assessed by patient's ability to touch the floor;
          - ability to lean forward, however, has more to do with hip flexion than lumbar spine flexion;
          - w/ forward flexion there should be a reversal of the normal lumbar lordosis;


- Palpation:
     - cva tenderness (pyelonephritis ect.)
     - paraspinal tenderness (osteoporotic kyphosis vs. tumor)
     - Waddel criteria


- Provocative Tests:
    - SLR (HNP vs. Diskitis)
    - Femoral Nerve Stretch Test (L3-4) HNP



- Reflexes:
    - Biceps................C-6
    - Tricep................C-7
    - Knee..................L-4
    - Ankle.................S-1
    - Babinski
    - Bulbocavernosus


- Motor:
    - Psoas......................L-2
    - Quadriceps.................L-3    L2-L3 disk
    - Tibialis Anterior..........L-4    L3-L4 disk
    - Ext. Hallucis..............L-5    L4-L5 disk
    - Gastrocnemius..............S-1    L5-S1 disk
    - Blad Sphincter.............S-2
    - Anal Sphincter.............S-3   (sacral sparing & cauda equina):


- Misc:
    - Instability and Wt Relief Flexion Test
    - Hoover Test


- Sacroiliac Joint Pain:
    - elicited with the patient lying on the affected side without support (Gaenslen's test), direct compression,
            or Flexion, Abduction and External Rotation (FABER test)



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, December 21, 2011 3:05 pm