Moderators: Rick Placide, MD, PT, Evan K. Johnson, PT, DPT, OCS
The relationship between conditions of the lower quarter and low back pain remains unclear despite frequent references in the medical literature. While it is widely recognized that LBP, postural faults and aberrant lower limb motion are interconnected the exact nature of the relationships remains opaque. In the past, the interdisciplinary spine care section has examined hip-spine syndromes where flexion deformities of the hip result in symptomatic spinal stenosis as well as how low back pain arising from limited hip mobility affects otherwise healthy athletes. In this symposium, we hope to expand upon this and bring to light some elements involved in lower limb mechanics beyond the hip joint that impact lumbopelvic mechanics and LBP. We will assemble a multidisciplinary panel of conservative care clinicians, surgeons and basic science researchers in spine in an effort to elucidate the impact of altered lower quarter mechanics on spinal pain and function. It is our hope that this will stimulate a conversation that can help to inform the spinal healthcare community and lead to more effective interventions for patients.
This symposium will review the etiology, clinical presentation and management of patients with concurrent spine and lower limb pathology. A multidisciplinary faculty will present on the interdependence of lower limb and lumbopelvic motion and the possible effects on lumbar spine conditions. Biomechanical considerations, examination techniques and treatment modalities in common conditions arising from concurrent spine and limb pathology will be reviewed. Indications for clinical examination techniques and treatment modalities in patients who present with concurrent lower limb and spine conditions will be presented. Presenters will emphasize the importance of utilizing reliable, sensitive and specific clinical examination techniques where they exist to screen the interdependent functions of the lumbopelvic limb complex.
Upon completion of this session, participants should gain strategies to:
- Recognize distinctive characteristics of the history, functional limitations and physical examination of individuals who present with pain and disability arising from concurrent spine and lower limb conditions;
- Integrate knowledge of lower limb and spine biomechanics with clinical findings to facilitate optimal triage of patients with pain and disability arising from concurrent lower limb and spine conditions in a manner consistent with best practice;
- Identify the advantages and disadvantages of specific clinical examination and treatment techniques for individuals who present concurrent lower limb and spine conditions;
- Enhance the use of best practice examination and treatment techniques of individuals with concurrent lower limb and spine conditions, based on the most current evidence
Agenda
Introduction/Welcome
Evan K. Johnson, DPT
What Does the Literature Tell Us About Lower Limb Conditions and Low Back Pain?
Evan K. Johnson, DPT
Interdependence of Lower Limb Kinematics and Lumbar Spine Alignment
Virginie Lafage, PhD
What Does Gait Analysis Tell us About The Effects of Lower Extremity Mechanics on the Lumbar Spine During Walking?
D. Casey Kerrigan, MD
Spinal Masqueraders: Disorders of the Lower Quarter That Mimic Spinal Conditions
Rick Placide, MD, PT
Audience Questions and Comments
Faculty Panel
Lower Limb and Lumbar Spine Degeneration: Physical Examination of the Patient with Concurrent Spine and Lower Limb OA
Rick Placide, MD, PT
Imaging and Ancillary Testing in Patients with Concurrent Spine and Lower Limb OA
John Metzler, MD
Surgical Decision Making: Spinal Fusion or Total Hip Arthroplasty
Aaron J. Buckland, MBBS, FRACS
Conservative Care Treatment Strategies for the Patient with Concurrent Spine and Lower Limb Conditions
Evan K. Johnson, DPT, OCS
Questions and Comments
Faculty Panel