Spine Physical Examination

Maria Florencia Deslivia

Cervical Spine

GENERAL EXAMINATION
 LOOK
• Deformity : front, side, behind
• Torticollis
– Congenital : SCM shortened to the tilting head
– Acquired : SCM shortened to the opposite of
tilting head
• Ex : atlantoaxial subluxation
https://www.orthobullets.com/spine/2052/congenital-
muscular-torticollis
Yang SY, Boniello AJ, Poorman CE, Chang AL, Wang S, Passias PG. A Review of the Diagnosis and
Treatment of Atlantoaxial Dislocations. Global Spine Journal.
 FEEL
• Palpate : anterior, posterior, lateral
• Bony eminence
• Tender spots?
• Muscle spasm?
 MOVE
• Do not move the Cervical in C-spine trauma !
• ROM : Flexion, Extension, lateral flexion,
rotation
• Movement  smooth and pain-free
• Shoulder girdle & c-spine are synchronous.
Shoulder symptom subsequently develop neck
pain, vice versa
45 deg 55 deg

40deg
70 deg
SPECIAL EXAMINATION
 SUBCLAVIAN OCCLUSION
• Adsons test : occlusion of subclavian artery by
m. scalenus or costae
• Palpate a. radial when abduction, extension,
and external rotation
 NEUROVASCULAR COMPRESSION
• Halstead maneuver
• Palpasi nadi radial
• Traksi tangan pasien ke bawah
• Kepala pasien posisi ekstensi
• +  paresthesia
 SPINAL CANAL STENOSIS
• Lhermitte sign
• Flexion
• +  pain radiating along spinal cord
• Dd/ MS, tumor
 NEURAL FORAMEN STENOSIS /
COMPRESSION
• Compression/ distraction test = Spurling test
• Pasien sit
• Compression : push down the head 
neck/ extremity pain
• Distraction : head traction  relieved
 RADICULOPATHY
• Doorbell sign
• Palpate C5  pain in scapulovertebra
radiating to the arm
• Local pain  sprain/strain
 LESI UMN
• Hoffman sign
• Flick DIP finger III
• + : Flexion of DIP finger I and II
Thoracolumbar Spine

GENERAL EXAMINATION
Pemeriksaan Fisik
Feel
Movement
SPECIAL TEST
• Bechterew’s test
– (+) = electrical or
shooting leg pain
– radiculopathy
THANK YOU