{"id":12820,"date":"2022-11-15T18:45:03","date_gmt":"2022-11-15T17:45:03","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=wiki&p=12820"},"modified":"2022-11-15T18:45:03","modified_gmt":"2022-11-15T17:45:03","slug":"interspinous-gap-change","status":"publish","type":"wiki","link":"https:\/\/www.physiotutors.com\/wiki\/interspinous-gap-change\/","title":{"rendered":"Interspinous Gap Change"},"featured_media":12821,"template":"","class_list":["post-12820","wiki","type-wiki","status-publish","has-post-thumbnail","hentry"],"acf":{"sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":12821,"background_image_alt_text":"Interspinous Gap Change"},"heading":"Interspinous Gap Change | Radiographic Lumbar Instability & Spondylolisthesis","subheading":"Lumbar Spine Assessment","content_editor":"","button_type":"internal_link","button_label":"Check our shop","button_style":"button-five","button_internal_link":4646,"button_anchor":"","button_url":"","button_file":"","label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Learn","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Assessment E-Book","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Reviews","button_internal_link":null,"button_anchor":"section-number-5","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"Become a member","button_style":"button-three","button_internal_link":16662,"button_anchor":"","button_url":"","button_file":""},"button_description":"Find this wiki on the Physiotutors platform"},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"

Learn<\/h4>"},"column_right":{"content_editor":"

Interspinous Gap Change | Radiographic Lumbar Instability & Spondylolisthesis<\/h2>\nThe Interspinous gap change is an orthopedic test to assess for lumbar spondylolisthesis and radiographic lumbar Instability.\nAhn et al. (2015)<\/a>\u00a0report a sensitivity of 82% and specificity of 61% when compared to lumbar flexion-extension radiographs using a cut-off value of 10\u00b0 for sagittal rotation and 4mm of sagittal translation. As there is no consensus on the classification of lumbar instability and this is the first study to evaluate this test the clinical value is at most moderate.\n
\n\n[embed]https:\/\/www.youtube.com\/watch?v=Jk1MxlQ98Us[\/embed]\n\n<\/div>\nTo conduct the test the patient stands approximately one leg-length away from the treatment table with the feet shoulder-width apart.\nThe patient is asked to flex the back forward with both hands on the edge of the treatment table.\nExamine the patient\u2019s spine from top to bottom and pay attention to the gaps between the spinous processes. If one level appears bent or the interspinous gap appears wider, focus on that region in the following step.\u00a0Continue by palpating the spine in cranial-to-caudal direction and evaluate the spaces between the spinous processes and the position of the upper compared to the lower spinous processes.\u00a0\u00a0If during inspection and palpation an area appears to have a wider superoinferior or anterioposterior gap, place one thumb on each of the spinous processes.\u00a0Then ask the patient to extend the spine by pushing the pelvis towards the treatment table while the examiner palpates the spinous processes.\n\nThe test is considered positive if the interspinous space abruptly becomes narrow compared with those of other levels or if the position of the upper spinous process in relation to the lower spinous process changes anteriorly or posteriorly from its original state. Furthermore, tenderness is usually detected during the flexion-extension motion when palpating interspinous spaces with wide gaps.\n\n[cta]\n\nThere are several other orthopedic tests for the diagnosis of radiographic lumbar instability:\n