Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ 738.4 Acquired spondylolisthesis ++ M43.00 Spondylolysis, site unspecified ++ 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Localized Inflammation +++ Description ++ Stress fracture of the pedicles on the vertebra belowTightness or pain across the back regionOften no symptomsWeakness in the pars +++ Essentials of Diagnosis ++ Diagnosis made by x-rayCan be acquired or congenitalBack pain +++ General Considerations ++ InstabilityAvoid extension positions that increase symptomsThin vertebral bone: pars +++ Demographics ++ Onset most often during teenage yearsRuns in families +++ Signs and Symptoms ++ Back painStiffness along spinePain in lumbar spine worsens with extension +++ Functional Implications ++ Difficulty maintaining standing postures secondary to back painInability to sleep flat on back without a pillowDifficulty with movements (bending over) secondary to painLimit sports participation +++ Possible Contributing Causes ++ Forceful extension as a result of a hit from behind (as in sports)CongenitalCar accident, hit from rearHyperextension of the lumbar spineIncreased lordosis posture +++ Differential Diagnosis ++ Peripheral nerve impairmentSpinal tumorPeripheral neuropathyParaspinal spasmsDegenerative disk diseaseStenosis +++ Imaging ++ MRI helps to visualize compressed or inflamed nerve root in diagnosisX-ray/plain-film radiograph to see vertebra positionCT to show herniation compressing the spinal canal/nervesElectrodiagnostic/nerve conduction testing can help to determine a specific impaired nerve function ++ Stress fracture of the pars ++ To hospital for imagingTo physician for surgical consult if myelopathy suspectedFusionDecompressionLaminectomyHemilaminectomyTo physician for corticosteroid injectionTo physician for anti-inflammatory medicationTo orthopedist for lumbar bracing ++ Restricted mobility of the lumbar spineHypermobilityNoted weakness noted of core musculature ++ RestBracingErgonomic trainingAddress painElectrical stimulationHeat/iceAddress hypertonicitySoft tissue massageHeatAddress muscle weaknessCore stability exercises ++ Patient will be able to Sit with neutral lumbar spine posture for greater than 30 minutes with 0 out of 10 pain ratingStand at work station and perform computer work for 45 minutes with 0 out of 10 pain ratingRotate lumbar spine in order to lift/pick up items off the floor with 0 out of 10 pain rating ++ Very good with proper ergonomic training, strengthening, and precautions ++1. The American Physical Therapy Association. Pattern 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Localized Inflammation. Interactive Guide to Physical Therapist Practice 2003. DOI: 10.2522/ptguide.3.1_5. Accessed March 5, 2012. ++2. Dutton M. Dutton's Orthopaedic Examination, Evaluation, and ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.