Moderators: Evan Johnson, PT, DPT, OCS; Leonard Voronov, MD, PhD
The relationship between decreased hip mobility and altered lumbar spine kinematics is evident in the literature. Progressive degeneration of the hip joint has been identified as a factor in the development of lumbar spine spondylosis and stenosis. Researchers have noted a complex hip-spine syndrome where flexion deformities of the hip result in increased loading of the lumbar spinal zygapophyseal joints as well as atypical postural findings. Low back pain arising from limited hip mobility is not confined exclusively to the elderly population and has been found to affect a large demographic of patients. In otherwise healthy athletes, hip stiffness and pathology have been linked to the development of spine injuries and has been found to be predictive of LBP in athletes.
This symposium will review the etiology, clinical presentation and management of patients with concurrent spine and hip pathology. A multidisciplinary faculty will present on the interdependence of hip and lumbopelvic motion and the effects of hip degeneration on lumbar spine conditions. Biomechanical considerations, examination techniques and treatment modalities in common conditions arising from concurrent spine and hip pathology will be reviewed. Indications for clinical examination techniques and treatment modalities in patients who present with hip-spine syndrome 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 hip 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 hip pathology;
- Integrate knowledge of hip and spine biomechanics with clinical findings to facilitate optimal triage of patients with pain and disability arising from concurrent spine and hip pathology in a manner consistent with best practice;
- Identify the advantages and disadvantages of specific clinical examination and treatment techniques for individuals who present concurrent spine and hip pathology;
- Enhance the use of best practice examination and treatment techniques of individuals with concurrent spine and hip pathology, based on the most current evidence.
Agenda
- Introduction/Welcome
Leonard Voronov, MD, PhD
- Hip-Spine Syndrome: What Does the Literature Tell Us About the Co-Occurrence of Hip Pathology and Low Back Pain?
Evan Johnson, PT, DPT, OCS
- Kinematics and Regional Interdependence of the Lumbar Spine and Lower Quarter
Peleg Ben-Galim, MD
- Progressive Hip and Lumbar Spine Degeneration: Evaluation of Hip-Spine Syndromes
Rick Placide, MD, PT
- The Impact of Hip Stiffness on Locomotion: How Does Hip OA Affect the Lumbar Spine During Gait?
D. Casey Kerrigan, MD
- Common Hip Injuries That May Present With Low Back Pain
Robert R. Turner, PT, MS, OCS
- Interventions for the Patient with Hip-Spine Syndrome
Clark Smith, MD, MPH
- Questions and Answers