Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2025-01-03T16:42:19.416Z Has data issue: false hasContentIssue false

Chapter 7 - Examination of the Adult Spine

Published online by Cambridge University Press:  22 April 2022

By
Antonia Isaacson ,
James Tomlinson  and
Neil Chiverton
Edited by
Fazal Ali  and
Nick Harris
Fazal Ali
Affiliation:
Chesterfield Royal Hospital
Nick Harris
Affiliation:
Spire Hospital, Leeds
Get access

Summary

Examination of the adult spine follows a similar sequence for the cervical, thoracic and lumbar spines. The lumbar spine is emphasised in this chapter. The stepsinclude: Stand the patient and inspect. This is followed by palpation and then movement of the spine. Ask the patient to walk and then perform a complete neurological examination. With a cervical spine examination, the nerological examination is of the upper and lower limbs, whereas in the lumbar spine it is just the lower limb. For the thoracic spine, abdominal reflexes should also be performed.

This chapter covers disc disease including myelopathy in more detail. Other important conditions are also covered such as the bulbocavernosus reflex and tandem spinal stenosis.

Keywords

spineASIA chartreflexmyotomedermatomeprovocation testmyelopathy
Type
Chapter
Information
Orthopaedic Examination Techniques
A Practical Guide
 , pp. 112 - 132
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Fairbank, JCT, Pynsent, PB. The Oswestry Disability Index. Spine (Phila Pa 1976) 2000;25(22):940–953.Google ScholarPubMed
Childs, JD, Piva, SR, Fritz, JM. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine (Phila Pa 1976) 2005;30(11):1331–1334.CrossRefGoogle ScholarPubMed
Hashizume, H, Konno, SI, Takeshita, K, et al. Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) as an outcome measure for patients with low back pain: reference values in healthy volunteers. J Orthop Sci 2015;20(2):264–280.CrossRefGoogle ScholarPubMed
Gluck, J V, Oleinick, A. Claim rates of compensable back injuries by age, gender, occupation, and industry. Do they relate to return-to-work experience? Spine (Phila Pa 1976) 1998;23(14):1572–1587.CrossRefGoogle ScholarPubMed
Murgatroyd, DF, Harris, IA, Tran, Y, Cameron, ID. The association between seeking financial compensation and injury recovery following motor vehicle related orthopaedic trauma. BMC Musculoskelet Disord 2016;17:282.CrossRefGoogle ScholarPubMed
Sanderson, PL, Todd, BD, Holt, GR, Getty, CJM. Compensation, work status, and disability in low back pain patients. Spine (Phila Pa 1976) 1995;20(5):554–556.CrossRefGoogle ScholarPubMed
Venkatesan, M, Nasto, L, Tsegaye, M, Grevitt, M. Bladder scans and post-void residual volume measurement improve diagnostic accuracy of cauda equina syndrome. Spine (Phila Pa 1976) 2019;44(18):13013–1308.Google ScholarPubMed
Adams, W. Lectures on the pathology and treatment of lateral and other forms of curvature of the spine. Br Med J 1865;1:484–486.Google Scholar
Waddell, G, McCulloch, JA, Kummel, E, Venner, RM. Nonorganic physical signs in low-back pain. Spine (Phila Pa 1976) 1980;5(2):117–125.CrossRefGoogle ScholarPubMed
Fairbank, J. Historical perspective: William Adams, the forward bending test, and the spine of Gideon Algernon Mantell. Spine (Phila Pa 1976) 2004;29(17):1953–1955.CrossRefGoogle Scholar
Schober, P. Lendenwirbelsäule und Kreuzschmerzen. Münch Med Wsclir 1937;84:336–338.Google Scholar
Castro, MP, Stebbings, SM, Milosavljevic, S, Bussey, MD. Construct validity of clinical spinal mobility tests in ankylosing spondylitis: a systematic review and meta-analysis. Clin Rheumatol 2016;35(7):1777–1787.Google Scholar
Stolwijk, C, Ramiro, S, Vosse, D, et al. Comparison of tests for lumbar flexion and hip function in patients with and without axial spondyloarthritis. Arthritis Care Res 2015;67(4):538–545.CrossRefGoogle ScholarPubMed
Macrae, IF, Wright, V. Measurement of back movement. Ann Rheum Dis 1969;28(6):584–589.CrossRefGoogle ScholarPubMed
American Spinal Injury Association. International Standards for Neurological Classification of SCI (ISNCSCI) worksheet, n.d. https://asia-spinalinjury.org/international-standards-neurological-classification-sci-isncsci-worksheet/ (accessed 26 March 2020)Google Scholar
Aids to the Examination of the Peripheral Nervous System. London: Her Majesty’s Stationery Office, 1976.Google Scholar
Jones, SJ, Miller, J-M M. Spurling Test. StatPearls Publisher, 2019.Google Scholar
Tong, HC, Haig, AJ, Yamakawa, K. The Spurling test and cervical radiculopathy. Spine (Phila Pa 1976) 2002;27(2):156–159.CrossRefGoogle ScholarPubMed
Shabat, S, Leitner, Y, David, R, Folman, Y. The correlation between Spurling test and imaging studies in detecting cervical radiculopathy. J Neuroimaging 2012;22(4):375–378.CrossRefGoogle ScholarPubMed
Davidson, RI, Dunn, EJ, Metzmaker, JN. The shoulder abduction test in the diagnosis of radicular pain in cervical extradural compressive monoradiculopathies. Spine (Phila Pa 1976) 1981;6(5):441–446.Google Scholar
Marie, P, Chatelin, C. Sur certains symptômes vraisemblablement d’origine radiculaire chez les blessés du crâne. Rev Neurol 1917;31:336.Google Scholar
McRae, R. (ed). Clinical Orthopaedic Examination, 6th ed. London: Churchill Livingstone, 2010; p. 41.Google Scholar
Lasegue, C. Considerations sur la sciatique. Arch Gen Med 1864;2:558.Google Scholar
McLain, RF, Dudeney, S. Clinical history and physical examination. In Fardon, DF, Garfin, SR (eds), Orthopaedic Knowledge Update: Spine 2. Rosemont, IL: American Academy of Orthopaedic Surgeons, 2002; pp. 39–51.Google Scholar
Dagi, TF, Tarkington, MA, Leech, JJ. Tandem lumbar and cervical spinal stenosis: natural history, prognostic indices, and results after surgical decompression. J Neurosurg 1987;66(6):842–849.CrossRefGoogle ScholarPubMed
Krishnan, A, Dave, BR, Kumar Kambar, A, Ram, H. Coexisting lumbar and cervical stenosis (tandem spinal stenosis): an infrequent presentation. Retrospective analysis of single-stage surgery (53 cases). Eur Spine J 2014;23(1):64–73.CrossRefGoogle ScholarPubMed
Fishbain, DA, Cutler, RB, Rosomoff, HL, Rosomoff, RS. Is there a relationship between nonorganic physical findings (Waddell signs) and secondary gain/malingering? Clin J Pain 2004;20(6):399–408.CrossRefGoogle Scholar
Fishbain, DA, Cole, B, Cutler, RB, et al. A structured evidence-based review on the meaning of nonorganic physical signs: Waddell signs. Pain Med 2003;4(2):141–181.CrossRefGoogle ScholarPubMed
Çelik, EC. Updates in ASIA examination: anorectal examination. Turk J Phys Med Rehab 2015;61(1):10–11. doi: 10.5152/tftrd.2015.00087.CrossRefGoogle Scholar
Guldner, GT, Brzenski, AB. The sensitivity and specificity of the digital rectal examination for detecting spinal cord injury in adult patients with blunt trauma. Am J Emerg Med. 2006;24(1):113–117. doi: 10.1016/j.ajem.2005.05.012.Google Scholar
Hoeritzauer, I, Pronin, S, Carson, A, et al. The clinical features and outcome of scan-negative and scan-positive cases in suspected cauda equina syndrome: a retrospective study of 276 patients. J Neurol 2018;265(12):2916–2926. doi: 10.1007/s00415-018-9078-2.CrossRefGoogle ScholarPubMed
Carolus, AE, Becker, M, Cuny, J, et al. The interdisciplinary management of foot drop. Dtsch Arztebl Int 2019;116(20):347–354.Google Scholar
Ma, J, He, Y, Wang, A, et al. Risk factors analysis for foot drop associated with lumbar disc herniation: an analysis of 236 patients. World Neurosurg 2018;110:e1017–e1024.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×