Lumbar Spondylosis
Lumbar Spondylosis is degenerative arthritis of the lumbar spine. It involves disc degeneration, facet joint hypertrophy, and osteophyte formation.
1. Lumbar Spinal Stenosis
The hallmark complication. Narrowing of the spinal canal compresses the cauda equina.
- Symptoms: Neurogenic Claudication (Pain/heaviness in legs while walking).
- Shopping Cart Sign: Patients lean forward to relieve pain (Flexion opens the canal).
2. Neurogenic vs Vascular Claudication
- Neurogenic: Pain walking downhill (Extension). Relieved by sitting/bending. Pulses normal.
- Vascular: Pain walking uphill (Muscle demand). Relieved by standing still. Pulses absent/weak.
3. Physiotherapy Management
- Williams Flexion Exercises: To open the spinal canal and foramina.
- Core Stability: To support the spine.
- Modality: Heat for muscle spasm.
25 Practice MCQs
Q1. The primary pathology in Lumbar Spondylosis involves:
Answer: A). "Wear and Tear".
Q2. Neurogenic Claudication is characterized by:
Answer: A). Extension narrows the canal; Flexion (sitting) opens it.
Q3. The "Shopping Cart Sign" refers to:
Answer: A). Flexion increases canal diameter.
Q4. Vascular Claudication is relieved by:
Answer: B). Does not require spinal flexion to relieve.
Q5. Which exercise protocol is preferred for Spinal Stenosis?
Answer: B). Extension worsens stenosis.
Q6. Facet Joint Arthropathy pain is typically worse with:
Answer: A). Loads the posterior elements.
Q7. "Vacuum Phenomenon" on X-ray indicates:
Answer: A). Sign of severe degeneration.
Q8. Lumbar Canal Stenosis is defined as AP diameter less than:
Answer: A). Relative stenosis. <10mm is absolute.
Q9. Normal lumbar lordosis is:
Answer: A). "Flat back" can occur in stenosis to open the canal.
Q10. Bicycle test helps differentiate stenosis because:
Answer: A). Vascular claudicants hurt with any leg activity. Neurogenic prefer flexion.
Q11. Traction is generally indicated for:
Answer: A). Contraindicated in instability.
Q12. "Kissing Spines" (Baastrup's Disease) involves:
Answer: A). Seen in excessive lordosis/degeneration.
Q13. Spondylosis can lead to Spondylolisthesis (Degenerative). True/False?
Answer: A). Facet degeneration allows slippage without pars defect.
Q14. Which ligament thickens and compresses the canal in stenosis?
Answer: A). It buckles inward during extension.
Q15. Decompressive Laminectomy involves:
Answer: A). Standard surgery for stenosis.
Q16. Core stabilization targets:
Answer: A). The "corset" muscles.
Q17. "Modic Changes" are seen on:
Answer: B). Marrow changes adjacent to degenerated discs.
Q18. NSAIDs are used to:
Answer: A). Symptomatic relief.
Q19. "Bamboo Spine" is NOT spondylosis, it is:
Answer: A). Marginal syndesmophytes bridging vertebrae.
Q20. Lateral Recess Stenosis compresses the:
Answer: A). Just before it enters the foramen.
Q21. Pelvic Tilt exercises help to:
Answer: A). Posterior pelvic tilt opens facets.
Q22. Epidural Steroid Injections are used for:
Answer: A). Reduces root inflammation.
Q23. Which segment is most mobile and prone to degeneration?
Answer: A). Followed by L5-S1.
Q24. Osteophytes are:
Answer: A). Body's attempt to fuse an unstable joint.
Q25. Walking downhill is painful for stenosis patients because:
Answer: A). Increases lordosis and narrows canal.
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