#spinerehabiltation #spinestabilization #spineexercises
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Dr. Coreman discusses biomechanics of the spine which is important for rehabilitation. If you understand what the spine does and why it does, then you can start to think about how to reverse these issues with a patient.
Here are the topics highlighted in this video: spinal function, lumbar spine anterior and posterior columns, facet anatomy, stabilizing ligaments, poster element physiology, normal MRI of Foraminal and axial views, values of motion for individual lumbar motion segments, sacroiliac joints, sagittal alignment, discal height changes, anterior “core” muscles, posterior muscular connections, spinal muscular function, multifidi force generation, normal lumbo-pelvic rhythm, pelvic rotation and muscle contraction, diurnal discal height changes, disc height loss with degeneration, rotation loads of annulus, flexion loads the posterior annular fibers, annular anatomy and tears, ligament stress and strain curve.
The importance of the following items are expanded upon:changes in disc mechanics with annular injury/degeneration of “running start”on annular forces, positional changes and effect on intradiscal pressure, mechanical stress with flexion on lumbar discs, biomechanics of lifting, mechanic stress with flexion on lumbar disc, BLT (bend, load, and twist), and new annular tears.
The center of rotation (COR) is hugely important. COR is the neutral point where structures in front and back at this point changer reciprocally.. Normally the center of rotation is the posterior 1/3 of the disc in extension and anterior disc with flexion. With degeneration, the COR changes dramatically. Dr. Corenman expands upon the following issues: how Spinal canal changes with flexion/extension, extension/narrowing of the lateral recess and foramen, central stenosis, basic rules of flexion and extension, pelvic rotation and lumbar lordosis, pathophysiology of the facets, enthesopathy, flat back syndrome and the causes, flat back (DDD), flat back stenosis, flat back isthmic spondylolisthesis, flat back thoracic hyperkyphosis, and flat back hip flexion contracture.
Lastly, Dr. Coreman examines the difference between scoliosis versus an antalgic positioning. With scoliosis vertebral rotation, there is vertebral rotation associated with the curve. The apex of the curve will demonstrate the most rotation. Depending upon the location of herniation, the antalgic list can be toward or away from a mass. There is no rotation with antalgic.
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With more than 30 years of experience, Donald Corenman, MD, DC, is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. His training as a Doctor of Chiropractic early in his career did not satisfy his desire for a deep understanding of the mechanics of the spine. This led him to medical school where he completed his Doctor of Medicine, Orthopedic Surgery Residency and Spine Surgery Fellowship. His study of spinal disorders and deformities brought him to Vail, Colorado where he joined The Steadman Clinic in 1994. With personalized clinical care a cornerstone of Dr. Corenman’s practice, he has been awarded the “Top 10 Doctor Award”, “Patient’s Choice Award”, “Compassionate Doctor Recognition” and is consistently recognized by Becker’s Spine Review in “Top Spine Surgeons to Know.”
Dr. Corenman has published two books: for patients, “Everything You Wanted to Know About the Back: A Consumers Guide to the Diagnosis and Treatment of Lower Back Pain” and for the medical community, “The Clinician’s Guidebook to Lumbar Spine Disorders: Diagnosis & Treatment”. He is passionate about educating patients on spine anatomy and disorders, so they have the ability to partner with their physicians in finding the most effective treatment for their back pain and disorders. His focus on peer education earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles.