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Comprehensive Back & Neuro Exam by Dr. Munir Saadeddin

Learn about back and neurological examination in patients with back pain, deformity, or lower limb symptoms. Understand history, standing, gait observation, supine and prone position exams, sensory testing, muscle power evaluation, and more. Explore clinical presentations, investigations such as X-rays, MRI, and biopsies, and muscle power evaluation techniques.

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Comprehensive Back & Neuro Exam by Dr. Munir Saadeddin

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  1. Back & Neurological Examination Dr Munir Saadeddin FRCSed

  2. Back & Neurological examinationWhich Patients? • Back Pain (- or +Leg Pain) • Back Deformity • Neurological symptoms of lower limb • Back Injury

  3. Back & Neurological Examination • History • Examination whilst standing out of bed • Gait observation • Examination in supine position • Examination in prone position

  4. Patient presenting & Back & Leg Pain

  5. Patient presenting with deformity

  6. Back Inspection (standing)

  7. Back Inspection (Forward Flexion)

  8. Back Inspection (Forward Flexion)

  9. Back Inspection in LBP

  10. Examination of forward flexion

  11. Examination of Lateral Flexion

  12. Examination of Back Extension

  13. Examination of Rotation

  14. Standing on Heels

  15. Standing on Tiptoes

  16. Back Examination in Supine Position • Does not include back inspection • SLR and Lasague maneuver should be done • Test the sensation (Dermatomes) • Test muscle power (Mainly EHL) • Test Reflexes

  17. SLR : Straight Leg Raising Test

  18. SLR: 0-80 degrees

  19. Lasague Maneuver

  20. Sensory Testing : Dermatomes

  21. Sensory Testing : Dermatomes

  22. Clinical Picture L4 Root Lesion

  23. L4 Neurological Signs

  24. Clinical Picture : L5 Root Lesion

  25. L 5 Neurological Signs

  26. S 1 Neurologic Level

  27. Clinical Picture : S 1 Root Lesion

  28. L4 & L5 Lesions

  29. L5 & S1 Lesions

  30. Investigations in Back Examination • Plain X rays: AP, Lateral, Oblique, Cone View &Tomograms • Blood Tests: CBC, ESR, Bone Biochemistry • Ct scan • Myelogram, Radiculogram • MRI • Biopsy (CT guided or Cannulated trocar under fluoroscopy)

  31. Plain X Ray : AP & Lateral

  32. Plain X Ray : Oblique 45 degrees

  33. Terry Dog & Scotty Dog appearance

  34. Scotty dog appearance

  35. Myelogram & radiculogram

  36. Radiculogram Left L5 Root Compression

  37. C T Scan :(Spondylolysis)=Defect in Pars Interarticularis

  38. C T : Intervertebral Disc Protrusion

  39. CT Myelogram

  40. MRI Lumbar Spine

  41. Isotope Bone Scan (Tc99m)

  42. Closed Vertebral Biopsy

  43. Closed vertebral biopsy

  44. Closed Vertebral biopsy

  45. Muscle Power Evaluation • Certain muscles at lower or upper limbs • We test Muscle Power NOT range of joint movements! • We give result by 0 - 5

  46. Hip Flexion : Iliopsoas Muscle

  47. Iliopsoas Muscle power Test

  48. Hip Adductor muscles( Obturator N)

  49. Hip Adductors Test

  50. Quadriceps Muscle (Femoral Nerve)

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