Clinical Anatomy and Mgmt of Back Pain [Vol 1- Low]

416 Pages·1997·99.3 MB·English

by  L. Giles

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Clinical Anatomyan d ManagemenotfLo w BackPai n
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CLINICAALN ATOMY
AND MANAGEMENT OF
LOW BACK PAIN
L.G .F GileMsS c,D C(C)P,h D
Reader
Departmenotf P ublHieacl tahn d TropicMaeld icine,
JamesC ookU niversiotyfN orthQ ueenslanTdo,w nsvilQluee,e nslanAdus,t ralia
ChieEfx ecutiOvffiec eran d ResearcDhi rector
NationaCle ntrfeo rM ultidiscSitpuldioinfeBaa srck y P ain,
TownsvilGleen eralH ospitaTlo,w nsvilQluee,e nslanAdu,s tralia
HonorarCyl inicSacli entist
TownsvilGleen eralH ospitaTlo,w nsvilQluee,e nsland, Australia
and
K. PS ingeMrS c,P T,P hD
AssociaPtreo fessor
Schooolf P hysiotherapy,
CurtiUnn iversiotfTy e chnology,
ShentoPna rk, WesterAnu straliAau,s tralia
HonorarRye searcFhe Uow
DepartmenotfsR adiologNy,e urojJathology and Bioengineering,
RoyalP erHtohs pitaPle,r thW,e sterAnu stralAiuas,t ralia
UTTERWORTH
E I N E M A I\l N
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Contents
Lisotf c ontributors vii 10 Biomechanoifct sh el umbosacral
Foreword ix spine 165
Preface xi MarJk.P earcy
Acknowledgements xiii
11S acroiljioaicn t 173
SectiIo Inn troductainodnE pidemiology LG.fG ileasn dC .MC.r awford
Introduction 3 12 Pathoanatoofmt yh et horacolumbar
L.G.GF.iJ es transitional 183
K.P.S inger
2 Thee pidemiology 18
PauSl hekelle 13 Miscellaneous
deveolpmental
SectiIfo nA natomayn d conditions 196
LG.fG iles
3 Introductory graphic
lumbosacsrpailn e 35
L.G.GFi les
Sectilfoln S pinaCll iniNceaulr oanatomy
4 Lumbarin tervertdeibsrcasl 49
andN europhysiology
JR.T ayloarn dL .G.Gfil es 14 Innervatoifos np inasltoJ r',',u'c t• u.Ir.'. e....s.- ,-2" 19
5 Zygapophys(ifaalc ejto)i nts 72 L.G.Gfi les
LG.fG iles
15N ervense,u ropeptiadneds
6 Spinaaln di ntervertceabnraalls 97
inflammatiinos np inatli ssues:
LG.fG iles mechanisms 231
7 Ligamenrtesl atteod MatsG ronblad
intervertceabnraall 114 16A natomayn d
HarolSd.A m onoo-Kuon
nervreo otasn d
MohammeGd. Y EI-Badawi compression 243
8 Bloosdu pployf KjeOlllm arker,
vertebrsapei,n al cord,r onoetsr ve BjorRny devik
andg anglia 134 17T hep athoanatobmaiscio sf s omatic,
HidezYoo shizaawnad H enryV ernoCn rock
autonomaincd n eurogensiycn dromes
9 Muscleasn dl igamenotfts h eb ack 156 originatiintn hge l umbosacsrpailn e 255
K,LM oore J RandyJ inkins
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viC ontents
SectiIVo nD iap,llosainsdM anagement 22 rn"u'o,£'n,r managemeonftl ow
paino fm echaniocrailg in
Irnaginogfrn cchaniacnadl
Burnasn dD ,R.
degenerastyinvder omoefst hel umbar
spine 275 23 Osteopatmhainca gemeonft
mechanicloawlb ackp ain 358
LindsayR]o.w e
TimM cCluneR,o berCtl arke,
19 Psychosocial oafbs apcekcp tasi n 314 Walkearn d Burton
BasJialm es McDonald
24 Phvsiothemraanpayg emeonftl ow
Diagnoosfim se chaniclaolwb ack paionf m echllalcalo rigin
painw itho rw ithourte ferrleedg StepheJn E dmondstoann dR oberLt. E lvey
pain 322
25 Contraindictaots ipoinnsa l
L.G.GFi les manipulation 387
21 Medicaanld s urgimcaanla gement K,PS inger
lowb ack mechanical
Section DefinitionAsb breviatiorlS
origin 334
Giles
BruceR .K nolmaycHLo benM cAlinuofl
andS amW Wiesel Index 401
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Contributors
HarolSd. Am onoo·Kuofi MB,C hB,P hD Mats GronblaMdD, PhD
ProfesosfoC rl inicalA natomy,e paDrmtent of AssociaPtreo fessaonrd S enior LecturienrP hyScial
AnatomyC olelge ofM edicine andKi ng Khalid Medicianned R ehabilitaUtniivoenr,sty i ofH elsinki,
Univeristy Hospital,Ri yadh,S audAir abia Finland
Mohammed G.YE.I ·BadaMwBi,B Ch,M S,M D BasilJ amesB Sc,M BBCh,F RANZCp,F RACp,
ProfesosfAo nra tomyC,o llegoefM edicine,S uez FRSPs ych
CanaUlni versity,I smaiJiEag,yp t ProfessoofrP s ychiatrya ndB ehaviouSrCaile nces,
Queensland,A ustraal i
Kim BurtonP hD,D O, MERgS
DirectSopri naRle searcUhn itU,ni versity of J.R andyJ inkins MD, FACR
HuddersfiUeKl d, DirectoofrN euroradiolUongiyev,rs ity ofT exas
HealtShc iencCee nteart S an AntoniOT,e xasU,S A
S.HBu.r ns DC(C),F CCS(C)
PrivaPtraec ticoef C hiropratcic,S askatoon, Shinichi Kikuchi MD, PhD
SaskatchewCaanna,d a Professaonrd C hairmaDn,ep artmento f
OrthopaedSiucr gerFyu,ku shima City,J apan
RobertC larkDeO
Associate Osetopath and eRsearch sAsociate,S pinal Bruce R.K nolmayerM D
ResearUcnhi tU,n ievrstyi ofH udclersfiUeKld , DepartmeonftO rthopedics,G eorgetowUnn iversity
MedicalC ente,rU SA
CM. CrawfordB AppSc(ChGirraod)D,i p(Neurosci),
FCCS(C) Robert McAlindon MD
ResearcFhe lloJwa,m esC ook University ofN orth Departmento fO rthopedics,G eorgetowUnn iverstyi
QueenslaTnodw,n svilAlues,t ralia MedicCaeln ter,U SA
Henry VernonC rockM D, MS,F RCS,FRA CS Tim McCluneD O
Honorary Senior LecturOerrt,ho paediDce partment, Asosciate Osteopatha nd Research Associate, pSinal
RoyalP osGtra duateM edicaSlc hoolH,a mmersmith ResearcUhn itU,n iversityo fH udderfiseld,U K
Hospital,Lo ndon
Frank McDonald
StepheJn. E dmondstonD ipPT ,A dv DipPT , PhD ClinicalP sychologistD,e partmento fP sychiatry,
LecturSecrho, olo f hPysoitherpay,C urtiUnn ievrsit,y TownsviHGee neralH ospitTaolw,n sville,
PertWhA ,A ustralia Queensland,A ustralia
Rober1t. E levyB AppSc,P GDipMT D.RM.i erauB SPED,C (C),M Sc(OrthF)C,C S(C)
SeniLoerctu rer,S chooolf P hysiotherapy,C urtin PrivaPtrea ctiocfeC hiropriacc,Sta skatoon
UniversPietrtyh, W A,A ustralia Saskatchewan,C anada
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Foreword
My themef ort hifso reworids' Bactko t heB asics'.B ackP ains,e emsp articulraerlleyv abnetc ausietg ets
SincWeo rlWda rI la,n dp articuliantr hleyp asdte cad,e backt ot heb asicAsl.t hougthh ef ocuiss o n manip­
thereh asb een an explosiionn the technologyu laticvaer et,h isse riefsul lrye cognizoepst imization
andt reat lowp ainy,e ti ti s caref or low disorderresq uirtehse i npuotf
ther atoef andc osts form ultipdlieS Ciplipnaerst.i culwahrelny conditiiosn
disproportiotnoa tcglrvo wtihn t he chroniocr d isabling.a uthorrse cognitlhea tth e
Theries n o advanciens disciplinesa common built
diagnositmiacg intge chniquseusc,h a sM RIa ndC T arountd het raditioannadln eweru nderstandoifn g
scannihnga,v ev astilmyp rovetdh ec linicicaanp'asc ityp atho-anataosmw ye,l la sp sychosoceivaeln twsh ich
tol esisn vasiviedleyn tipfya tholowghyi cht hreatenss hapeo ur individuraels ponsteo p ains timulain,d
neurolofguincc tiAolns.o t,h eriesn od oubtth atth ese how thiisn fluenfucnecst ioncaalp aciItnys .h ortth,i s
advances irnprovetdh ec are wortheyf fo\'! to
sturctural sllcahs dl;Jgnosainsd
comeo ft het reatmeonfmt a jor irnpl'Ovementi n greateorr,
primary andn eurologic fractures reduced
ands omei nfectiaosnw se,l als t hec aroef t hoswei th What ares omeo ft hec ritiucnadle prininngc on­
clearmlayn ifedsits hce rniatiaonndss pinaslt enosis.c eptwsh ichw ililm provteh ev aluoef c aref ort hose
Realistictahlelsyec, o nditioancsc ounfto ra small withb ackd isorders?
minoriotfly o wb ackd isorders. Thep ractitinoeneedrs t ou nderstagnrdo sasn at-
During decadteh ere and histopatho!Moogrle. i mportanits t he
societal ofh ow health clinicaaclu men differentiwahteet he'ra bnormal'
andh ow measureTdh.i s evideinnt anatomiys t he ofs ymptoms,s implay
wherem arket forcehsa vc featuorfea ging. a narrov,;ed S d1i sc
promotead v eryr apigdr owtihn m anagedc areT.h e spacsee eno n planrea diograpihsss urelays sociated
challenignec reaSinpgolsye dt o provideirss t o withh istolocgihca ngeo f degeneratiyoent,t he
explicidtelmyo nstratthee valueo f the servicesp resencoef t hifsi ndipnrge dicltist talbeo utth el ikely
renderewdh,e re vailsum ee asurebdy qualiotfyt he causoef p ainE.v enm orep erplexiinsgt heo bservation
outcome, thes ervice, When value significantp rotrusiaornes
ism easured explicit careo fl ow ofp eoplweh o havee xperienced
back pain founwda nting. eX;lmptlhee,r e backt ot he messagae ,g ood
isa g rowing whichs how, cosotf s pinal examinationf,a rm ore int he
fusiofno r madneyg eneratdiivseo rdeirshs i gher thavna smta joriotfyp eoplwei tha cutbea ckp aint hant he
alternactaivree , ando utthceo meass m easurebdy mosts ophisticiamtaegdi ntge sts.
relioefsf y mptomasn dfu nctioans,w elals a highr ate Similaral syy,s temataipcp roactho t reatmeanntd
ofc omplicatisoungsg,e tshte p roceduhraes m arginal managemenitsc ritifcoraa ll wlh o engagien t hec are
value. patienOtns . allopathic tlnally
Thee vitipe;lIlH� ldiostx h aats technology becominagw are manipulativc has
hase volved, seeansb y majori.tyo fu sers, SCientificparlolvye ne fficacOyn. the hand,
hasm arginailmlpyr oveIdn.t his thec urrent engageidn m ;mipuiatitvree atment recog-
volumeC,l inicAanla tomya ndM anagemento f Low nizweh ent hep atienpta'tsh oloigsny o ta menablteo
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