ONE Lumbar Spine

Question 1

Straight Leg Raise

Answer 1

• Space occupying lesion (herniated disc) at sciatic nerve and spinal nerve roots L5, S1, and S2
• Patient supine. Raise the patient’s leg to a point of pain or 90
• • Pain 0- 35° –piriformis, SI joint lesion, disc herniation
• • Pain 35-70° – sciatic nerve roots tense – pain due to disc pathology radiculopathy
• • Pain after 70 – sacroiliac joint
• Lower leg to decrease symptoms
• Repeat with dorsiflexion and/or neck flexion
• Follow dermatome path to nerve root

Question 2

Well Leg Raise

Answer 2

Crossover Sign
• Straight Leg Raise Test
• +Pain/radiculopathy on opposite leg • – space occupying lesion
• Leg raised on unaffected side – nerve roots on opposite side slide towards midline

Question 3

Bragards Test

Answer 3

Patient supine. Raise leg to point of pain. • Lower the leg 5°and dorsiflex the foot.
• +Pain due to traction of the sciatic nerve. • +Pain with dorsiflexion at 0° to 35°
• Extradural sciatic nerve irritation
• +Pain with dorsiflexion from 35°– 70°
• Intradural problem, intervertebral disc lesion
• +Dull posterior thigh pain • Hamstring hypertonicity

Question 4

Kemps Test why is this diff?

Answer 4

Patient seated or standing.
• Stabilize the PSIS with one hand.
• Reach around the patient with the other hand • Passively extend the lumbar spine obliquely
• +Pain in the lower
• Lumbar spasm
• Facet capsulitis
• Radicular pain - a disc lesion

can also be for thoracic!