Acute disc herniation

Spinal stenosis

Spinal stenosis with an acute disc herniation

Scoliosis

• Examination includes the exclusion of non-musculoskeletal causes.
• Examination includes an assessment of any sensory or motor deficit.
• Assessment of structurally obvious abnormalities.
• Reflexes are tested.
• Bowel and bladder assessment are done.
• Other special clinical testing where appropriate.

Lateral flexion

Rotation

Flexion & extension

Inspect Palpate

Flexion

Extension

Lateral flexion

Rotation

Muscle groups are tested for power and graded accordingly

Resisted shoulder abduction

Resisted arm flexion

Resisted wrist extension

Resisted elbow extension

Resisted finger flexion

Resisted finger abduction

Resisted hip flexion (hip flexor muscles)

Resisted knee extension

Resisted ankle dorsiflexion

Resisted big toe extension (Extensor Hallucis Longus muscle)

Resisted foot plantarflexion

Upper limb reflexes

Lower limb reflexes:

• Patellar
• Ankle

Patellar reflex test

• Radiological investigation may include X-rays, CT and/or MRI scans.
• Blood investigations where clinically relevant.

• Correct diagnosis for appropriate management.
• Treat the specific cause and contributing factors.
• Non surgical management include analgesia and rehabilitation.
• Surgery management in selected cases for the specific underlying cause.

Spine fusion:

Decompression and spine fusion with pedicle ad rod fixation