2 Anatogghhghhhmy2 lumbar vertebrae.pptx

LUMBAR VERTEBRAE
REEMA ALTAF
DPT, MS-NMPT

Lumbar Anatomy vertebrae L1-L5
Massive bodies and kidney shaped
Characteristics
The pedicles and laminae are shorter and thicker than other vertebrae
The spinous processes are short, flat, and hatchet shaped and are easily seen
when a person bends.
Processes project backward for attachment of back muscles
The vertebral foramen is triangular
The orientation of the facets of the articular processes of the lumbar vertebra
lock the vertebrae together and keeps the rotation of the lumbar spine

Sacral Anatomy
The sacrum is a series of 3, 4, or 5 fused
coccygeal vertebrae
The coccyx articulates with the inferior aspect
of the sacrum

LumbarSpineAnatomy-Typicallumbarvertebra(L2)
Body
Vertebral foramen/canal
Intervertebral foramen
Pedicle
Transverse process
Lamina
Spinous process
Facet joints
Pars interarticularis

Ligaments
Anterior longitudinal ligament
Posterior longitudinal ligament
Ligamentum flavum
Interspinous ligaments
Supraspinous ligament
Intertransverse ligaments

Lumbar Spine Anatomy Nerve Structures
The spinal cord and nerve roots are often
affected by skeletal problems
Discs and bony tissue can interfere with normal
nerve function and cause pain

Prevention of Injuries to the Spine
Lumbar spine
◦ Avoiding stress
◦ Correction of biomechanical abnormalities
◦ Using correct lifting techniques
◦ Core stabilization

Recognition and Management of Lumbar
Spine Injuries
Low back muscle strains
Cause: sudden extension with trunk rotation, chronic strains, faulty posture
S&S: diffuse or localized pain, pain with active extension and passive flexion
Care: cold pack initially, abdominal support, stretching and strengthening; focus
on hamstring flexibility; core strengthening

Recognition and Management
of Lumbar Spine Injuries
Lumbar Sprains
Cause: forward bending and twisting while lifting an object,
acute or chronic
S&S: localized pain just lateral to the spinous process, pain
becomes sharper with certain movements or postures,
extension and rotational movements increase pain
Care: RICE initially, brace, stretching, strengthening, NSAIDs

Myofascial Pain Syndrome
Cause: mechanical stress to muscles, strains or postural positions;
regional pain with referred pain to a specific area that occurs with
pressure of tender spots or trigger points
S&S: point tenderness on a specific spot that radiates pain; sharp,
achy pain
Care: stretching, strengthening, deep tissue massage, modalities

Sciatica
Cause: inflammatory condition of the sciatic nerve that
can accompany recurrent or chronic back pain,
particularly vulnerable to torsion or direct blows.
S&S: abruptly or gradually; sharp, shooting pain, that
follows the nerve pathway along the medial and
posterior thigh; tingling and numbness, sensitive to
palpation
Care: rest, lumbar traction with disk protrusion,
stretching, NSAIDs

Herniated lumbar disk
Cause: faulty body mechanics, trauma, or both, usually forward bending and
twisting - most often L4-L5
S&S: centrally localized pain that radiates unilaterally to buttocks and down back
of leg, or pain that spreads across the back; worse in am, onset is sudden or
gradual, pain may increase after sitting, decrease with extension
Care: goal = reduce protrusion and restore normal posture, rest and ice, manual
traction, back extensor and abdominal strengthening

Spondylolisthesis
◦ Slippage of one vertebrae on the one below it, a complication
of spondylolysis that often results in hypermobility of a
vertebral segment, highest incidence is L5 slipping on S1,
“scotty dog deformity”

S&S: persistent mild to moderate aching pain across the low back
(LB) or stiffness in LB with increased pain after but not usually during
activity; the need to change positions frequently or the need to self
manipulate the LB to reduce pain, localized tenderness, possible
neurological symptoms
Care: bracing, bed rest for 1-3 days, rehab directed towards
exercises that control or stabilize the hypermobility segment,
abdominal strengthening is key

Spondylolysis
Cause: degeneration of the vertebrae or defect in the pars
interarticularis of the articular process; often attributed to a
congenital weakness and occurs as a stress fracture

Rehabilitation
◦ 3 main components to work on:
1. Hamstring flexibility
2. Abdominal strength
3. Flexible and strong back musculature

2 Anatogghhghhhmy2 lumbar vertebrae.pptx

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