腰椎小关节问题的坐位四象试验

 

• Patient seated with arms folded, practitioner standing behind them
• Practitioner passively moves patient into flexion to the right and compresses spine by bearing down on their shoulders .
• Next moving into flexion to the left and repeat procedure .
• Follow this by taking patient into left  and right extension and compressing again.
• If we can imagine this to be providing compressive forces into 4 separate corners such as the 4 legs on a chair for example. We would be compressing each chair leg in turn.
• Although all tests are not definitive, if we observe the anatomy we should by flexing the spine, open up the facet joints but instead put pressure on the anterior portion of the lumbar discs.
• If pain is reproduced and neurological symptoms such as sciatic pain occurs then this may indicate disc herniation and nerve root impingement.
• If pain is produced when patient is moved into extension then this begins to compress the facet joints,and if they are responsible the symptoms will be aggravated.