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94 Cards in this Set
- Front
- Back
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In gait cycle when leg goes forward, innominate goes ___, leg backward, innominate goes ____
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posterior, anterior
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How many degrees of motion are available at sacroiliac joint?
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5
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What maintains SD at sacroiliac joint?
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lig tension - joint subluxation locking
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What is a dys from LE restricting ilium or sacrum?
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iliosacral dys
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What is dys from spine restricting sacrum or ilium?
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sacroiliac (sacral) dys
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What is the innervation of sacroiliac joint?
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S1-5
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What is the term for segmental inn of periosteum, ligs, fascia?
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sclerotome
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What 3 things cause false + w/ standing flexion test?
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asymmetric hamstrings, sacral dys, L4/5 dys
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What is the most common pelvic dys?
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post innominate rotation
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What is dx of PSIS caudad and sacral sulcus deep?
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post rotation of innominate
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What m is used in ME tx of post rotated innominate?
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rectus femorus
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What is pain assoc w/ ant innominate rotation?
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low back pain radiating to abdomen
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What is dx of PSIS cephalad, shallow sacral sulcus?
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ant rotated innominate
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What 2 m are used in ME tx of ant rotated innominate?
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glut max, hamstring
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Where is pain for sup innominate shear?
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pain in post sacroiliac ligs
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What is dx of PSIS cephalad, ischial tuberosity cephalad, lax sacrotuberous lig?
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sup innominate shear
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What is used in ME tx of sup innominate shear?
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respiratory assisted motion of sacrum
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What condition is very painful over sacro- iliac, tuberous, spinous ligs?
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inf innominate shear
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What is dx of PSIS caudad, ishial tuberosity caudad, tight sacrotuberous lig
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inf innominate shear
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What is used in ME tx of inf innominate shear?
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resp assisted motion of sacrum
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Where will pain be for inflare?
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medial to PSIS
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What is dx of ASIS closer to midline?
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inflare
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What m is used in ME tx of inflare?
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adductors of hip
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Where will pain be for inflare?
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ipsi inguinal lig
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What is dx of ASIS farther from midline?
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outflare
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What 3 m are used in ME tx of outflare?
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tensor fascia lata, glut min, piriformis
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What m are used in ME tx of sup symphyseal shear?
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adductors
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What condition may be mistaken for intra-abd pathology?
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inf symphyseal shear
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What m is used in ME tx of inf symphyseal shear?
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glut max
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What m is used in ME tx of pubic symphysis gapping?
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glut med
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What m is used in ME tx of pubic symphysis compression?
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adductor m
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Level of biceps tendon reflex?
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C5
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Level of brachioradialis tendon reflex?
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C6
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Level of triceps tendon reflex?
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C7
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Level of patellar tendon reflex?
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L4
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Level of achilles tendon reflex?
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S1
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Level of superficial anal reflex?
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S2-4
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When is HVLA of C-spine contraindicated?
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vertebrobasilar compression due to hyperext or rotation
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What are 5 consequences of >1/2" leg length inequality?
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arch collapse (long side), osteoarthritis (long side), piriformis syn (long side), ov cyst (short side), infertility
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What is def'n of spondylolysis?
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lytic defect of pars interarticularis
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What is pathognomonic for spondylolisthesis?
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gait changes - stiff-legged, short stride, waddling; >grade II
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What study is done w/ neuro deficits in lumbar region?
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EMG/NCV
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What study is done w/ sensory deficits in lumbar region?
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SSEP/DEP if EMG/NCV normal
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What spondylolisthesis is congenital defect of spinal arch or lumbosacral facets?
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dysplastic
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What spondls. is lytic fx of pars?
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isthmic subtype A
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What spondls. is elongated pars?
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isthmic subtype B
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What spondls. is acutely fx pars?
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isthmic subtype C
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What is cause of majority of spondls.?
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isthmic
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What spondls. is due to osteoarthritic changes of apophyseal joints?
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degenerative
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Degenerative causes of spondls. usually occur where?
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L4
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What spondls. is due to fx of vertebrae outside of pars?
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traumatic
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What cause of spondls. causes congenital curved joints, lumbosacral agenesis, joint contractures?
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arthrogryposis
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What are the 2 types of spondls. grading?
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Meyerding (I-IV), Taillard (%)
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Which sacral axis is where sacrum flex/ext due to truncal motion?
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middle tverse
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What is normal motion about middle tverse axis of sacrum?
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flex/ext w/ spine, further flex=ext, further ext=flex
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Where is middle tverse axis located?
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ant S2
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Where is sup tverse axis located?
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post S2 at sup sacroiliac ligs
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Which sacral axis moves w/ ventilation?
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sup tverse
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What is normal motion of sacrum about sup tverse axis?
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inhalation=ext; exhalation=flex; cranial base flex=ext; cranila base ext=flex
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What sacral axis moves w/ cranial rhythmic impulse cycle?
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sup tverse
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What sacral axis moves w/ gait cycle?
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inf tverse axis
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Where is inf tvers axis of sacrum?
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ILA
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What sacral axis is helical?
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oblique
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What is cause of tlation along AP axis of sacrum?
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trauma
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What is pelvic axis of rotation?
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vertical
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What are indicators of unilateral sacral dys?
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+ seated flexion, asymmetrical sulci and ILA compared to eachother
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What are 3 characteristics of ant sacral torsion?
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ext from lumbar spine, exaggeration of gait cycle, back and butt ache
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What are 3 characteristics of post sacral torsion?
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flex from lumbar spine, not caused by gait cycle, intense low back and piriformis pain
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What are findings of bilateral sacral dys?
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very deep/shallow sulci compared to normal, + sacral rock (no motion)
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Where do organs near diaphragm radiate pain to?
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shoulder (C3-5)
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Where do organs inn by vagus refer pain to?
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occipital region
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T1-4 inn?
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everything above diaphragm
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T5-9 inn?
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GI tract to middle tverse colon, liver, gall bladder, pancreas, spleen
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T10-L2 inn?
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middle tverse colon to anus, urinary tract, adrenals, repro organs, vasomotor control of LE
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S2-4 inn?
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mid tverse colon to anus, urnary tract, adrenals, repro organs, vasomotor control of LE
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What dys will a viscero-somatic reflex cause in thoracic and lumbar spine?
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Type II extended
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Where does thyroid dz refer pain?
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T1-4 (symp aff), C3-5 (dermatomes)
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What makes the pain as facet osteoarthrits diffuse?
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facet joints are inn by level segment and segment above and below
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What inn the outer third of annulus fibrosis posteriorly?
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recurrent meningeal n
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What inn ant long lig and outer third of annulus fibrosis anterolaterally?
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visceral afferents from sympathetics
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Where are the unconvertable joints of Lushka of the spine?
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C2/3 - C7, in the anterolateral VB
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What are 7 steps of osteoarthritis of synovial joint?
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articular SD, facet synovitis, cartilage degenerates, capsular laxity, facet subluxation, osteophyte formation, facet and laminar enlargement
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What are the 7 steps of disc degeneration?
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circumferential microtears, radial tears, disc herniation, circumferential bulging, disc narrowing, osteophyte formation, VB enlargement
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What are the irritants released when nucleus pulposus herniates?
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H+, phopholipase A2, IgG, stromelysins
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What causes posterior joint syn?
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facet synovitis, circumferential annular tears
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What causes instability?
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facet capsular laxity and internal disc disruption
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What causes dynamic lateral stenosis?
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facet subluxation and disc narrowing
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What positions make lateral stenosis worse?
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extension and rotation
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What are 3 differences in neurogenic claudication vs vasc claudication?
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NC resolves quickly, improves walking uphill, does not improve w/ flexed posture
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Is lateral stenosis releived by flex or ext exercises?
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flexion
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Is central disc herniation tx in flex or ext?
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ext
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What are 3 conditions that happen in the stage of instability of spinal degeneration?
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dynamic lateral stenosis, degenerative spondls, degenerative retrolisthesis
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What causes stage of stabilization of spinal degeneration?
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osteophytes, bony enlargement, lig and capsule hypertrophy
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What are 2 conditions that happen in stage of stabilization of spinal degeneration?
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fixed lateral stenosis and central canal stenosis
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