Benevolent Leader. Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension,...
Full Answer
What is normal thoracolumbar spine forward flexion?
40% – forward flexion measures 30 degrees or less; or, the entire thoracolumbar spine is frozen in a favorable position. 20% – forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees.
What is thoracolumbar segmental movement?
During movement of the thoracic and lumbar spine, the combined movement of all facet joints in the thoracic and lumbar spine (called thoracolumbar movement) or just the lumbar spine is measured because segmental motion is very difficult to measure accurately.
What is spinal flexion and deformity?
Flexion of the Spine and Deformity. Along with kyphosis, spinal flexion as a daily habit over time may contribute to scoliosis or sway back. In these conditions, the chronic spinal flexion position is called the "saggital" component. Saggital refers to movement, in this case of the spine and trunk, that goes in forward or backward directions.
What is the thoracolumbar spine?
The thoracolumbar spine is what most people refer to as their back. Think of it as your middle and lower back. The other part of your spine is what we would commonly call your neck. VA uses medical terminology and refers to your neck as your “cervical spine”. Look for me to discuss how VA rates cervical spine disabilities in future articles.
What does forward flexion mean?
Flexion is the anatomical name for forward bending. When treating back pain, many spine specialists encourage exercises to strengthen the muscles that act to bring the spine into flexion.
What are the typical ranges of motion at the thoracolumbar spine?
Normal ranges of motion for the cervical spine include 50 degrees of flexion, 60 degrees of extension, 45 degrees of lateral, or side bending, and 80 degrees of rotation. The ranges of motion for the thoracic spine include 30 degrees of rotation and 50 degrees of kyphosis.
How is forward flexion of the thoracolumbar spine measured?
2:183:10Goniometric Measurement: Lumbar Flexion Range Of Motion ... - YouTubeYouTubeStart of suggested clipEnd of suggested clipThe stationary arm bisecting. The SSPs is the axis on the iliac crest. And then the mobile arm isMoreThe stationary arm bisecting. The SSPs is the axis on the iliac crest. And then the mobile arm is going to be bisecting. It's going to be the mid-axillary line so in the middle of the armpit.
Where is the thoracolumbar spine?
Thoracolumbar spine is the transitional zone between the stiff thoracic cage and the mobile lumbar spine. Therefore, it is a vulnerable region for injury, including fracture and dislocation.
How much flexion is in the thoracic spine?
From neutral, the thoracic spine can flex to approximately 35 ° of additional flexion. Thus, in full flexion, the thoracic spine demonstrates up to 75 ° of flexion. Conversely, the thoracic spine only moves 20 ° to 25 ° of extension.
What range of motion is most limited in the lumbar spine?
More distally, at the lumbosacral level, the joint line has a more coronal plane, which makes rotational movements potentially possible, but these are limited by the iliolumbar ligaments. The total range of rotation in the lumbar spine is therefore very limited, although not completely zero.
How do you test the spine ROM?
1:343:22Active ROM Assessment for the Thoracolumbar Spine - YouTubeYouTubeStart of suggested clipEnd of suggested clipLeft loudly flex. And I want you to run your fingers along the outside of your lower extremity. AndMoreLeft loudly flex. And I want you to run your fingers along the outside of your lower extremity. And I can stabilize your pelvis. And we are looking for about 45 degrees.
How do you test for lumbar flexion?
0:281:43Schober Test for Lumbar Spine Flexion - YouTubeYouTubeStart of suggested clipEnd of suggested clipAnd another 110 centimeters above measure the distance between the two points which should be 15MoreAnd another 110 centimeters above measure the distance between the two points which should be 15 centimeters. Then the patient flexes as far as possible keeping the legs fully extended.
How is spinal flexion measured?
Using the fingertip-to-floor method, the distance from the third fingertip to the floor is measured, first with the patient standing erect, and then after the subject laterally flexes the spine. The change in distance from erect standing to lateral flexion is considered the range of lateral flexion (see Fig. 8-52).
How do you treat thoracolumbar spine?
The vertebral body is not seriously damaged in flexion-distraction injury; thus, it is mostly treated by the short segment fixation. However, recently, only posterior instrumentation without fusion is often used for the treatment. Because there is no fusion process, it can be conducted by percutaneous screw fixation.
What is the symptoms of thoracolumbar spine?
Patients with thoracolumbar fractures typically have significant, localized back pain and stiffness. However, patients with other injuries may complain of pain in other areas and not notice the severity of back pain. Patients who have neurologic compression or irritation may have numbness or weakness in the legs.
What thoracolumbar means?
Medical Definition of thoracolumbar 1 : of, relating to, arising in, or involving the thoracic and lumbar regions thoracolumbar spine fractures.
How is thoracic spine range of motion measured?
Using the fingertip-to-floor method, the distance from the third fingertip to the floor is measured, first with the patient standing erect, and then after the subject laterally flexes the spine. The change in distance from erect standing to lateral flexion is considered the range of lateral flexion (see Fig. 8-52).
How many degrees of rotation occurs in the lumbar spine?
The lumbar spine has very little in the way of rotation movement. Its total rotational degrees are around 13 from top to bottom according to Shirley Sahrmann. Each individual segment from has around 2 degrees of rotation.
How is thoracic spine mobility measured?
1:013:47Screening for thoracic spine mobility in athletes - YouTubeYouTubeStart of suggested clipEnd of suggested clipOkay a quick test to determine. If he has compensatory motion through a thoracic spine is to doMoreOkay a quick test to determine. If he has compensatory motion through a thoracic spine is to do shoulder active shoulder elevation and to see to see what happens it's Justin elevates his shoulder.
What is spinal flexion?
A familiar movement for most of us, spinal flexion is the act of bending forward. It's what you're specifically told not to do when lifting heavy items, gardening, and other manual tasks. Understanding how flexion works and its effects on the body may help manage your back pain. OJO_Images / Getty Images.
What is bending forward called?
Whether you're exercising, gardening, playing with your kids, or doing housework—any of these bending movements have specific names based on the direction that your spine goes while performing them. There's flexion, or bending forward; extending, which is an arching back type movement; side bending, also known as tilting; and rotation, or twisting.
What is the term for the movement of the spine and trunk?
In these conditions, the chronic spinal flexion position is called the "saggital" component. Saggital refers to movement, in this case of the spine and trunk, that goes in forward or backward directions.
How to prevent back pain from spinal flexion?
The easiest way to prevent back problems that arise from chronic spinal flexion is to keep your core , which includes your ab and back muscles, both flexible and strong.
How long does it take for a herniated disc to heal?
Herniated disc injuries sometimes get better without surgery, but this can take a year or so. 1 With conservative care only, symptoms tend to dissipate once the disc material is resorbed into the body. Physical therapy can help manage the pain while you wait, should you decide to go this route.
What is the name of the disc that breaks when it is herniated?
A herniated disc occurs when the outer covering of a spinal disc, which is known as the annulus fibrosus , frays or breaks, and the disc's liquid center ( nucleus pulposus) leaks out.
How to strengthen your back?
A back exercise program should help you do this. In particular, yoga and Pilates not only strengthen muscles, but they also develop your spinal alignment. 3 With these systems, you'll exercise your back in all the directions your spine can move.
What is 20% flexion?
20% – forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis
How does a flare up affect a veteran's disability?
If veterans are service-connected for back conditions, the presence of flare-ups could impact their disability ratings. Specifically, a higher rating may be awarded when there is additional loss or limitation of motion due to pain during flare-ups. For example, a veteran is granted service connection for a back condition and receives a 10 percent disability rating. On most days, the veteran is unable to bend forward more than 60 degrees. However, when experiencing a flare-up, the veteran is unable to bend more than 30 degrees. Therefore, during the flare-up, the veteran’s back condition becomes much more disabling than 10 percent. As such, VA should assign a disability rating in accordance with this additional loss.
Can back flare ups affect disability?
If veterans are service-connected for back conditions, the presence of flare-ups could impact their disability ratings.
What is the lumbar spine?
Your lumbar spine consists of the five bones (vertebra) in your lower back. Your lumbar vertebrae, known as L1 to L5, are the largest of your entire spine. Your lumbar spine is located below your 12 chest (thoracic) vertebra and above the five fused bones that make up your triangular-shaped sacrum bone.
What are the muscles and other soft tissues of the lumbar spine?
Your lumbar muscles, along with your abdominal muscles, work to move your trunk and lower back. Your muscles and ligaments provide strength and stability to your lower back and allow you to bend forward, backward and rotate. The muscles that attach to your lumbar spine include:
What are the nonsurgical treatment options for lumbar spine conditions?
Your healthcare provider may first recommend less invasive approaches for lumbar pain that aren’t caused by trauma or a tumor. Some common nonsurgical treatment options include:
Is having minimally invasive lumbar spine surgery a possibility?
Speak with your surgeon. In most cases, minimally invasive spine surgery has replaced open surgery. Compared to the one large incision through your skin with traditional open surgery, minimally invasive surgery is performed through one or more smaller incisions. Working through smaller incisions causes much less damage to muscles and soft tissues than a single long incision.
How to measure lateral flexion of spine?
Two methods for using a tape measure to examine lateral flexion of the spine have been introduced in the literature, with neither method becoming predominant in clinical use. These two methods include placing marks at the lateral thigh and the fingertip-to-floor method.
Which spine is oriented laterally?
This alignment of facets in the thoracic spine promotes the main motions of lateral flexion and rotation. The facet joints of the lumbar spine are formed by combination of the facet surfaces of two vertebrae, which lie in the sagittal plane, with the inferior facet surface of the superior vertebrae (oriented laterally), ...
How many vertebrae are there in the thoracic spine?
Twelve vertebrae (composed of the superior and inferior vertebral facets, the vertebral bodies, and the discs that are interposed between the vertebral bodies) make up the thoracic spine, and five make up the lumbar spine. A typical lumbar vertebra is pictured in Figure 8-1, and a typical thoracic vertebra is pictured in Figure 8-2.
What is segmental motion?
Segmental motion in the thoracic and lumbar spine occurs as the top vertebrae slide onto the bottom vertebrae (arthrokinematic movement), whereby the facet joints of the spinal segment contribute to and guide the motion. Although segmental movements at each vertebra are small, combined movement in the entire thoracic and lumbar spine produces large range of motion (ROM) in the spine. During movement of the thoracic and lumbar spine, the combined movement of all facet joints in the thoracic and lumbar spine (called thoracolumbar movement) or just the lumbar spine is measured because segmental motion is very difficult to measure accurately. Through segmental motion at each vertebra in the thoracic and lumbar spine, osteokinematic movements of flexion and extension occur in the sagittal plane, right and left lateral flexion in the frontal plane, and right and left rotation in the transverse plane.
Which vertebrae are facet joints?
The facet joints of the thoracic spine are formed by the facet surfaces of two vertebrae, which lie in the frontal plane with the inferior facet surface of the superior vertebrae (oriented anterior and slightly inferior) articulating with the superior facet surface of the inferior vertebrae (oriented posterior and slightly superior). This alignment of facets in the thoracic spine promotes the main motions of lateral flexion and rotation.
Which connective tissue connects the vertebrae to form intervertebral cartilaginous joints?
A general overview of the connective tissue of the thoracic and lumbar spine includes the intervertebral disc, which connects the vertebral bodies to form intervertebral cartilaginous joints, and the following supporting ligaments: anterior longitudinal, posterior longitudinal, ligamentum flavum, intraspinous and supraspinous (Fig. 8-3).
How much lumbar flexion is required to put on socks?
Putting on socks required 90% lumbar flexion. Picking up a small object from the floor required almost full lumbar flexion (95%). Therefore, putting on socks and picking up a small object from the floor required almost twice as much lumbar ROM as was required for sit/stand activities.
What is flexion injury?
Flexion Injuries of the Spine. The spine is a very delicate part of the body that serves a number of important functions including providing motor and sensory functions to the entire body. Because of this, anyone with injuries of the back should be evaluated promptly by a trained medical professional. Some of the statistics related ...
What happens if you stretch your spine?
If the nerves of the spinal cord are stretched to the point of avulsion, they could be damaged. This can lead to pain that requires regular medication. Vertebral Fractures: Extreme flexion injuries of the spine can even lead to a fracture of the vertebrae. As they stretch, the edges of the bones could start to break.
How many days do you lose from work due to back injuries?
People who sustain back injuries lose an average of 12 days from work as a result of their injuries. About $50 billion are spent every year in this country as a result of back injuries.
Can a flexion injury occur in the spine?
While the spine needs to be able to bend forward to some extent, it is also capable of bending over too far. This is how a flexion injury of the spine might occur. There are several injuries that people could sustain, including: Avulsion injuries of the roots of the spinal cord nerves. Sprains of the ligaments and tendons.
What is the cervical spine?
Cervical Spine. Your cervical spine supports and enables you to move your head. It's made up of seven vertebrae and is shaped like an inward "C" called a lordotic curve. Flexion is dropping your chin to your chest, and the normal ROM is 45 degrees. Extension is dropping your head back and looking up.
How many vertebrae are in the thoracic spine?
The thoracic section of your spine is made up of 12 vertebrae and shaped like a backward C, called a kyphotic curve. The lumbar spine is made up of five vertebrae, and it curves in like the cervical spine in a lordotic curve. Together, these vertebrae allow you to perform the major movements of the spine.
What is the spinal column made of?
Your spinal column is made up of vertebrae that allow movement.
What is the degree of spinal motion?
All movement starts from a neutral position, standing up straight, arms to your sides and eyes straight ahead. This is 0 degrees. The four movements measured are flexion, extension, lateral flexion and rotation.
What is the normal ROM for flexion?
Together, these vertebrae allow you to perform the major movements of the spine. The normal ROM for flexion or forward bending is 90 degrees. For extension, it's approximately 30 degrees. The normal ROM for side bending and rotation is also 30 degrees.
How does VA rate thoracolumbar spine?
VA has two methods from rating thoracolumbar spine disabilities. The most common way that VA rates thoracolumbar spine disabilities is a range of motion formula. VA looks at the flexion that you have at your waist and whether is is limited as a result of your back disability. A 20 percent rating requires your flexion to be pretty limited.
What are the two parts of the spine?
It is actually composed of two parts of the spine: 1 The thoracic spine which is made up of twelve vertebral bodies 2 The lumbar spine which is made up of five vertebral bodies
What percentage of thoracolumbar VA rating?
VA does provide three other ways to get a 20 percent thoracolumbar VA rating. Muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis.
What does the VA call the back?
VA uses the term “thoracolumbar spine” to refer to what most people would call their back. This articles will focus on VA’s rules for rating disabilities of the thoracolumbar spine.
How many vertebrae are in the lumbar spine?
It is actually composed of two parts of the spine: The thoracic spine which is made up of twelve vertebral bodies. The lumbar spine which is made up of five vertebral bodies. The other part of your spine is what we would commonly call your neck. VA uses medical terminology and refers to your neck as your “cervical spine”.
Does the VA factor back pain?
It’s another way to rate a spinal condition. Having back pain or some limitations alone will not be enough to qualify for the 20 percent VA rating since VA define s incapacitating episodes.
Are there other ways to get a 20 percent VA rating for the thoracolumbar spine?
Sometimes, I find that veterans with significant back disabilities have pretty good range of motion. So, they do not qualify for a 20 percent rating under VA’s range of motion rules.
Definition
Causes
Symptoms
- A herniated disc occurs when the outer covering of a spinal disc, which is known as the annulus fibrosus frays or breaks, and the disc's liquid center (nucleus pulposus) squirts out. If the nucleus pulposus happens to land on a spinal nerve root, as it often does, you'll likely experience pain and/or other nerve symptoms, collectively known as radiculopathy.
Treatment
- Herniated disc injuries sometimes get better without surgery, but this can take a year or so. With conservative care only, symptoms tend to dissipate once the disc material is resorbed into the body. Physical therapy can help manage the pain while you wait, should you decide to go this route. But many people who sustain a herniated disc want a quicker fix, so they opt for a discect…
Examples
- Sitting at the computer, driving and carrying children are examples of activities that may lend themselves to this type of postural misalignment.
Clinical significance
- Along with kyphosis, spinal flexion as a daily habit over time may contribute to scoliosis or sway back. In these conditions, the chronic spinal flexion position is called the \"saggital\" component. Saggital refers to movement, in this case of the spine and trunk, that goes in forward or backward directions.
Research
- And you may want to consider acupuncture, as well. A March 2018 study published in the journal BMC Complementary and Alternative Medicine compared medication, exercise, and acupuncture for managing lumbar spinal stenosis. Of the three treatments, acupuncture resulted in the most improvement both for symptoms and physical functioning.
Prevention
- The easiest way to prevent back problems that arise from chronic spinal flexion is to keep your core, which includes your ab and back muscles, both flexible and strong.
Results
- Obviously, a back exercise program should help you do this. In particular, yoga and Pilates not only strengthen muscles but they also develop your spinal alignment. With these systems, you'll exercise your back in all the directions your spine can move. Plus, their emphasis on balanced action and whole-body alignment may help re-establish an erect posture.