1. SPINE examination

2. History taking
SYMPTOMS
Pain (especially what inc. and what
decrease )
Sciatica
Stiffness
Deformity
Numbness or paraesthesia
Urinary symptoms
Other

3. Examination of Spine
Signs with the patient standing
Look
Skin
Shape and posture
Feel
Tenderness
Move
Flexion / Extension
Rotation / Lateral flexion

4. Examination of Spine
Signs 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

5. Cutaneous distribution of
nerve roots

6. Muscle Power Testing (MRC
Scale
0 Total paralysis
1 Barely detectable contracture
2 Not enough to act against gravity
3 Strong enough to act against
gravity
4 Still stronger but less than normal
5 Full power

7. Cauda Equina Syndrome
Large midline disc prolapse
Compresses several nerve roots
Sphincter disturbance
Saddle anaesthesia
Prompt surgical intervention

8. 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

9. Scoliosis
Idiopathic Scoliosis
80% of all scoliosis
Adolescent - age 10 or over
Juvenile - age 4 to 9
Infantile - age 3 or under

10. Kyphosis
Postural (Round back)
Compensatory
Structural