Spine Notes
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sensory disturbance of the hands, mm wasting of hand intrinsics, unsteady gait, hoffman's reflex, hyperreflexia, B/B Problems, Multisegmental wkness/sensory changes | show 🗑
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show | Red Flag: NEOPLASTIC CONDITIONS
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show | Red Flag: UPPER CERVICAL LIGAMENTOUS INSTABILITY
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show | Red Flag: VERTEBRAL ARTERY INSUFFICIENCY
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show | Red Flag: INFLAMMATORY OR SYSTEMIC DISEASE
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show | 1. Symptom duration <30 days
2. No symptoms distal to the shoulder
3. FABQPA <12
4. Looking up does not aggravate symptoms
5. Cervical ext <30
6. Flat T3-T5
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show | 1. Initial NDI <11.5
2. Bilateral involvement pattern
3. Not performing sedentary work >5 hrs/day
4. Feeling better with movement
5. Did not feel worse while extending neck
6. Diagnosis of spondylosis without radiculopathy
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What are the adjunct treatments for all patients with neck pain? | show 🗑
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What are the criteria for the mobility category? | show 🗑
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show | -Mobilizations: opening/closing/traction
-MET
-Soft tissue techniques (suboccipital release)
-AROM exercises
-Thoracic/CT Manipulations
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show | 1. Referral of pain into the upper extremities/hand
2. Radiculopathy
3. Referral to mid-scapular area
4. Peripheralization with AROM
5. Increased symptoms with closing pattern (<60 SB, Rot ipsi)
6. +Spurling, ULTTA, Distraction Test
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show | 1. Ipsilateral cervical rotation <60
2. ULTTA
3. Distraction Test
4. Spurling's Test
+LR= 30
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show | Goal: centralize symptoms, decrease pn and disability.
-Mechanical cervical traction
-Manual cervical traction
-Traction manip
-Chin retraction ex
-Lateral slide glide with neurodynamic positioning
-Thoracic/CT Manip
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show | 1. Higher level of pain and disability
2. Very recent onset of symptoms
3. Referred or radiating symptoms into upper quarter
4. Cervicogenic HA
5. Difficult exam due to exacerbation of sxs
6. Poorly tolerates manual or movement interventions
7. Trau
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show | Goal: decrease pn and disability, permit further examination
-Thoracic/CT Manip
-Gentle AROM
-Gentle massage
-Modalities
-Activity modification
-Short term cervical collar
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What are the criteria for the exercise/conditioning category? | show 🗑
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How would you treat someone in the ex/cond category? | show 🗑
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show | 1. Unilateral HA "ram's horn"
2. Onset preceded by neck pn
3. Triggered by neck movement or positions
4. Reproduced by pressure on posterior neck
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How would you treat someone in HA category? | show 🗑
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