Lumbar Spondylosis

LUMBAR
SPONDYLOSIS
Presented by :
Rezki Tri Wahyuni S.
C111 12 143
Residen Advisors :
dr. William Limoa
dr. Ricky M. Tambunan
dr. Moh. Asri Abidin
Advisors :
dr. Jainal Arifin, M.Kes., Sp.OT(K) Spine
Orthopedic And Traumatology Department

Faculty Of Medicine
Hasanuddin University
2018
DEFINITION
O Lumbar spondylosis can be
interpreted as a change in the
spinal joint with characteristic
increase in intervertebral disc
degeneration which is followed by
changes in bone and soft tissue, or
can mean excessive growth of
bone (osteophytes),
O Mainly located in the anterior,
lateral, and sometimes posterior
from superior edges and inferior
vertebra centralis.
Rahayu, Sri. 2011. Penatalaksanaan Fisioterapi pada Spondylosis L4-S1 di RSAL Dr. Ramelan Surabaya. Karya Tulis Ilmiah: UMS
Fajrin, Iniyati. 2008. Penatalaksanaan Fisioterapi dengan Infra Red, Tens, dan William Flexion Exercise pada Kondisi Low Back Pain karena Spondilosis Lumbalis. Karya Tulis Ilmiah: UMS
ANATOMY
O Figure 1. Columna Vertebralis
Peng, B., et al. 2005. The Pathogenesis of Discogenic Low Back Pain. Vol 87: 62-67. Journal of Bone and Joint Surgery. Available from :
https://www.ncbi.nlm.nih.gov/pubmed/15686239 Diunduh 30 july 2018
ANATOMY
O Figure 2. Structure of Columna Vertebralis Lumbal
Guyton, A.C. dan Hall, J.E. 2001. Buku Ajar Fisiologi Kedokteran, Alih bahasa: Setiawan, I. dan Santoso, A. EGC: Jakarta
RISK FACTOR
Age >
40 years
Sitting
habits
Obesity
are ugly
postures
Sitting for
a long
time
PATHOGENESIS
Discus is
narrowing 
Discusive osteophytes
progressive
Disc changes
degeneration
(increasing
age)
IN YOUNG PEOPLE, THE DISC CONSISTS
OF FIBROCARTILAGE WITH THE GELATINUS
MATRIX. IN ELDERLY  SOLID AND
IRREGULAR FIBROKARTILAGO
Price, Sylvia A. Dan Lorraine M.Wilson. 2006. Herniasi Diskus Intervertebralis Dalam Patofisiologi Konsep Klinis Proses-Proses Penyakit.
EGC: Jakarta.
CLINICAL MANIFESCATION
Low back pain
Leg pain and numbness (Anesthesia)
motor weakness in the lower extremities
Characteristics of lumbar spondylosis are pain and motion stiffness in

the morning
Middleton, Kimberly dan David E.Fish. 2009. Lumbar Spondylosis: Clinical Presentation and Treatment Approaches. Vol 2:94-104. Pubmed.
Available from : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697338/ Diunduh 30 july 2018
SUPPORTING EXAMINATION
MRI
CT-Scan
X-RAY
Suhadi, Irwan. 2006. Gambaran Klinis dan Radiologi kasus Low Back Pain Di Rumah Sakit Immanuel Bandung Periode 2002-2005. Karya
Tulis Ilmiah: Universitas Maranatha.
Figure 1 : AP Position Figure 2 : Lateral Position

NORMAL RADIOLOGY OF LUMBAR
Imaging of Lumbar Spondylosis

Imaging of
Spondylosis
(Sagital CT scan)
Imaging of
Spondylosis
(Sagital MRI)
TREATMENT
Conservative
• Non Medikamentosa
• Medikamentosa
Surgery
• Three groups of operating procedures that can be carried out,

including:
• Decompression operation
• The combination of decompression and stabilization of
unstable motion segments
• Unstable motion segment stabilization operation
Thamburaj V. Lumbar spondylosis. 2007. In: http://www.pubmedcentral.nih.gov. Accses : Agustus 2018

PHYSIOTHERAPY
Short-term Long-term
O Reducing pain O Restore physical
O Reduce spasm of the capacity and
piriformis and
gastrocnemius muscle functional ability
O Reduces contractures of
to walk.
hamstring muscle
O Release clip on the spinal
nerve
Fajrin, Iniyati. 2008. Penatalaksanaan Fisioterapi dengan Infra Red, Tens, dan William Flexion Exercise pada Kondisi Low Back Pain karena
Spondilosis Lumbalis. Karya Tulis Ilmiah: UMS
PHYSIOTHERAPY
Short Wave Diathermy (SWD) William flexion exercise.
O SWD is a therapeutic O William flexion exercise

modality that produces is exercise program
electromagnetic consisting of: 6 kinds of
energy with high movements that highlight
frequency alternating a decrease in lumbar
current. lordosis (lumbar flexion
occurs).
PHYSIOTHERAPY
William flexion exercise.
O This training method for :

O Reduces pain and give lower trunk
stabilization resulting in increased
flexibility / elasticity in the hip flexor
muscle groups and lower back (sacrospinal) .
O Restore / improve the work balance
between flexor and extensor postural
muscle groups.
William flexion
exercise.
A. Exercise I
This movement for stretching the extensor trunk muscles,

mobilizing the hip joint and strengthening the abdominal muscles.
William flexion
exercise.
B. Exercise II
This movement for stretching the extensor trunk muscles,

strengthening the abdominal muscles, and the
sternocleidomastoid muscle.
William flexion
exercise.
C. Exercise III
This movement for close the lumbar arch, extend the

extensor trunk muscles, hip joints, sacroiliac joints and
hamstring muscles.
William flexion
exercise.
D. Exercise IV
This movement for close the lumbar arch, extend the

extensor trunk muscles, hip joints, sacroiliac joints and
hamstring muscles.
William flexion
exercise.
E. Exercise V
This movement for extend/stretch the hip flexor

muscles and latae fascia.
William flexion
exercise.
F. Exercise VI
This movement for strengthen the quadriceps

muscle, abdominal muscles and extensor trunk.
COMPLICATION
As we seen this position

makes patient more
comfortable regardless of
normal posture.
Scoliosis
Peng, B, et al. 2005. The Pathogenesis of Discogenic low back pain. Vol 87: 62-67. Journal of
bone and joint surgery
PROGNOSIS
The prognosis of lumbar spondylosis is

good enough and can be cured within a few
weeks.
Peng, B, et al. 2005. The Pathogenesis of Discogenic low back pain. Vol 87: 62-67. Journal of
bone and joint surgery
CONCLUSION
O Lumbar spondylosis is a change in the spinal joint with
characteristic increase in intervertebral disc degeneration
which is followed by changes in bone and soft tissue, or can
mean excessive growth of bone (osteophytes).
O Lumbar spondylosis is a clinical manifestation of neurogenic
claudication if it has affected the spinal nerve.
O In addition to medical therapy, physiotherapy can be done to
restore and solution disorder and limited activity
experienced by the patient.
O Physiotherapy that can be done, among others: Soft Wave
Diathermy and William Flexion Exercise.

Lumbar Spondylosis

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LUMBAR

Orthopedic And Traumatology Department

O Figure 1. Columna Vertebralis

O Figure 2. Structure of Columna Vertebralis Lumbal

Low back pain

Leg pain and numbness (Anesthesia)

motor weakness in the lower extremities

Characteristics of lumbar spondylosis are pain and motion stiffness in

Figure 1 : AP Position Figure 2 : Lateral Position

Imaging of Lumbar Spondylosis

• Three groups of operating procedures that can be carried out,

Thamburaj V. Lumbar spondylosis. 2007. In: http://www.pubmedcentral.nih.gov. Accses : Agustus 2018

Short Wave Diathermy (SWD) William flexion exercise.

O SWD is a therapeutic O William flexion exercise

O This training method for :

This movement for stretching the extensor trunk muscles,

This movement for stretching the extensor trunk muscles,

This movement for close the lumbar arch, extend the

This movement for close the lumbar arch, extend the

This movement for extend/stretch the hip flexor

This movement for strengthen the quadriceps

As we seen this position

The prognosis of lumbar spondylosis is

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