Extrinsic lesions
Urogenital system - tumour / stones
Gastrointestinal system
Vascular system - AAA
Intrinsic lesions
Trauma
- fracture, HNP, facet dislocation
Infection
- vertebral osteomyelitis, TB
Tumour
- benign / OO / OB / ABC / Giant cell
- primary malignant / Ewing's / OS / Lymphoma
- secondary malignant / metastasis / MM
Inflammatory
- RA
- seronegative
Metabolic
- gout / CPPD / onchronosis
Endocrine
- PTH
Neuromuscular
- spinal dysraphism
Degenerative
Dysplasia
- Achondroplasia, dysraphism
Congenital
- Scheurmann's
Waddell's Signs
3 or more to be significant
DR TOS
1 Distraction
- FLIP SLR (Sign 1)
2 Regional
- Non-anatomically numb or weak
- Esp Cogwheel Give Way
3 Tenderness
- Superficial "Pinch Test" (Sign 2)
- Non-anatomic
4 Over-Reaction
Collapse
Verbalisation
Sweating
5 Simulation
- Axial loading by head compress
(Sign 3)
- Passive Pelvic rotation (Sign 4)
2° Thoracic rotation
Successful Discectomy
6/6 Nachemson
1. Leg pain > back pain
2. Neurological symptoms dermatomal
3. Neurological signs dermatomal
4. Signs of nerve tension
5. Correlation with imaging
6. > 6 weeks