Foreword viii
Author Biographies ix
Chapter 1 Introduction 1
Chapter 2 General Principles 3
2.1 Anatomy of the Spine and Nervous System 3
2.2 Pathophysiology of Disk Damage 16
2.3 Pain 24
2.4 Functional Limitation: Objective and Subjective Aspects and Questionnaires 29
2.5 Epidemiology and Risk Factors 33
Chapter 3 Medical Diagnosis and Treatment 36
3.1 Medical History and Clinical Examination 37
3.2 Technical Diagnostic Procedures 40
Chapter 4 Diagnosis in Physical Therapy 49
4.1 Medical History 49
4.2 Diagnosis by Observation 50
4.3 Movement Tests of the Spine 52
4.4 Examination of Nerve-gliding Capacity 53
4.5 General Instructions for Filling out Diagnostic Assessment Forms 54
4.6 Diagnosis 57
Chapter 5 Therapy 63
5.1 Overview 63
5.2 Course of Treatment 66
5.3 Basic Procedure in Physical Therapy for Patients with Disk Damage 68
5.4 Mechanical Effect of the Therapy on the Disk Injury 70
5.5 Mobilization of the Nervous System 71
5.6 Assessment of the Therapy and Evaluation of a Possible Change of Treatment Strategy 73
5.7 Indications for Surgery 74
5.8 Postoperative Therapy 74
Chapter 6 Lumbar Spine 76
6.1 Diagnostic Assessment Form for the Lumbar Spine 76
6.2 Diagnosis by Observation 76
6.3 Diagnostic Tests 78
6.4 Establishing the Diagnosis 88
6.5 Therapeutic Procedure with a Diagnosis of Disk Damage 90
6.6 After an Operation 105
6.7 Case Study 106
Chapter 7 Thoracic Spine 112
7.1 Diagnostic Assessment Form for the Thoracic Spine 112
7.2 Diagnosis by Observation 113
7.3 Diagnostic Tests 113
7.4 Establishing the Diagnosis 120
7.5 Therapeutic Procedure with a Diagnosis of Disk Damage 121
7.6 After an Operation 131
Chapter 8 Cervical Spine 133
8.1 Diagnostic Assessment Form for the Cervical Spine 133
8.2 Diagnosis by Observation 133
8.3 Diagnostic Tests 133
8.4 Establishing the Diagnosis 142
8.5 Therapeutic Procedure with a Diagnosis of Disk Damage 144
8.6 After an Operation 151
8.7 Case Study 153
Chapter 9 Rehabilitation and Prevention 162
9.1 Posture Training 163
9.2 Stability 164
9.3 Mobility 167
9.4 Sitting 167
9.5 Lifting 168
9.6 Strength 170
9.7 Coordination and Balance 172
9.8 Cardiovascular Fitness 172
9.9 Individual Compensatory Movements 173
Chapter 10 Diseases Occurring in Association WITH Prolapsed Disks 177
10.1 Additional Diseases With Mechanical Effects on the Spine 177
10.2 Nonmechanical Additional Diseases 179
Chapter 11 Psychosocial Risk Factors 180
Chapter 12 Selected Studies on the Topic of Spinal Disorders 183
12.1 Breig A, Troup JDC. Biomechanical considerations in the straight-leg-raising test. Cadaveric and clinical studies of the effects of medial hip rotation. Spine. 1979;4:242-250 184
12.2 Maigne JY, Deligne L. Computed tomographic follow-up study of 21 cases of nonoperatively treated cervical intervertebral soft disk hemiation. Spine. 1994;19:189-191 185
12.3 Donelson R, Aprill C, Medcalf R, Grant W, A prospective study of centralization of lumbar and referred pain. Spine. 1997; 22:1115-1122 186
12.4 Brötz D, Küker W, Maschke E, Wick W, Dichgans J, Weller M. A prospective trial of mechanical physiotherapy for lumbar disk prolapse. J Neurol. 2003;250:746-749 188
12.5 Weinstein JN, Tosteson TD, Lurie Jd, Tosteson ANA, Hanscom B, Skinner JS et al. Surgical versus nonoperative treatment for lumbar disk herniation. The Spine Patient Outcomes Research Trial (SPORT): a randomized trial. JAMA. 2006a;296:2441 -2450 190
12.6 Functional Investigation of the Lumbar Spine and the Spinal Canal in Flexion, Extension, and Neutral Position in Patients with Lumbar Disk Prolapse, Using Magnetic Resonance Tomography: Capture of Morphological Changes 192
Chapter 13 Significance, Types, and Objectives of Clinical Studies 196
Glossary 199
Bibliography/References 202
Index 213