A New Technique for Measuring Lumbar Segmental Motion In Vivo

Steffen, Thomas; Rubin, Rick; Baramki, Hani G.; Antoniou, John; Marchesi, Dante; Aebi, Max

doi:10.1097/00007632-199701150-00006

Cited by 80 publications

(59 citation statements)

References 41 publications

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“…This result confirms the findings of several studies analyzing elementary motion of the lumbar spine [3,16,18,22], although some other authors have described coupling as constant (while differing from segment to segment) and well established [15,17]. Several studies have shown that lateral bending is accompanied by rotation to the same side, but that coupling is variable during rotation [16,22]. Coupling characteristics are probably influenced by several parameters, of which lumbar lordosis and posture, muscular control and intrinsic mechanical properties are most frequently put forth [8,16,17].…”

Section: Discussionsupporting

confidence: 91%

“…In particular, the coupling between axial rotation and lateral bending was analyzed. Although still a matter of controversy, coupling of bending and rotation during elementary trunk motion has been studied by several authors [3,8,16,17,18,22]. However, little is known about this aspect during gait, despite the fact that such information might be useful in fundamental and clinical conditions for several disorders or deformities, such as idiopathic scoliosis and chronic low back pain.…”

Section: Feipel T De Mesmaeker P Klein M Roozementioning

confidence: 99%

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Three-dimensional kinematics of the lumbar spine during treadmill walking at different speeds

Feipel¹,

Mesmaeker²,

Klein³

et al. 2001

European Spine Journal

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IntroductionWalking is for humans one of the most natural activities. However, although it is well known that the lumbar spine is of primary importance in gait [11] and that its development is influenced by the upright posture adopted in human locomotion [21], little is known about the kinematic behavior of the lumbar spine during this daily activity.Several biomechanical aspects of the lumbar spine during walking have been studied previously. For instance, the resultant forces on lumbar discs and facet joints during walking have been shown to reach 2.5 times the body weight [4], although lower and higher peak loads have been described [7,9,13,14]. A recent in vivo study by Wilke et al. [32], for example, showed much lower intradiscal pressures during gait, which were only moderately larger than those registered during relaxed standing or sitting. It is, however, not known whether these pressures are altered in patients with low back disorders. Lumbar loads during gait have been shown to increase with increasing walking velocity [7], although this finding remains controversial [32]. Peak erector spinae contraction forces during walking (140 N) are larger than those of the remaining trunk muscles (about 15 N) [9]. A study by Vink and Karssemeijer [28] showed bilateral activity of Abstract The lumbar spine is of primary importance in gait and its development is influenced by the upright posture adopted in human locomotion. However, little is known about the kinematic behavior of the lumbar spine during walking. The aim of this study was to examine (1) lumbar spine kinematics during walking, (2) the effect of walking velocity on lumbar motion patterns and (3) the coupling characteristics of rotation and bending. In 22 volunteers aged 15-57 years, the three-dimensional displacements of T12 to the sacrum were sampled during elementary movements of the trunk and during walking on a treadmill at four walking velocities. A three-dimensional electrogoniometer (CA 6000 Spine Motion Analyzer) sampling at 100 Hz was used. We analyzed maximal primary and coupled motion ranges (ROM) and velocities in each plane. Lumbar ROM during walking did not exceed 40% of maximal active ROM. Transverse plane ROM and frontal and transverse velocities increased with walking velocity. Coupling of rotation and bending during walking was individually variable and dependent on walking velocity. Moreover, the smoothness of the bending-rotation path varied with walking velocity. A simplified envelope of lumbar coupling characteristics during walking is presented, and the existence of an individually variable walking speed that is characterized by a more harmonic lumbar contribution is hypothesized.

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Section: Discussionsupporting

confidence: 91%

Section: Feipel T De Mesmaeker P Klein M Roozementioning

confidence: 99%

Three-dimensional kinematics of the lumbar spine during treadmill walking at different speeds

Feipel¹,

Mesmaeker²,

Klein³

et al. 2001

European Spine Journal

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“…A pathologic movement of the intervertebral motion segment is considered to be the origin of symptoms [15,23,24,28]. As defined by Panjabi, lumbar instability would imply that the spine has lost the ability to maintain its pattern of displacement under physiologic loads and thus avoid neurological deficits, incapacitating deformity and intractable pain [27].…”

Section: Introductionmentioning

confidence: 99%

Grading of degenerative disk disease and functional impairment: imaging versus patho-anatomical findings

Quint

Wilke

2008

Eur Spine J

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Degenerative instability affecting the functional spinal unit is discussed as a cause of symptoms. The value of imaging signs for assessing the resulting functional impairment is still unclear. To determine the relationship between slight degrees of degeneration and function, we performed a biomechanical study with 18 multisegmental (L2-S2) human lumbar cadaveric specimens. The multidirectional spinal deformation was measured during the continuous application of pure moments of flexion/extension, bilateral bending and rotation in a spine tester. The three flexibility parameters neutral zone, range of motion and neutral zone ratio were evaluated. Different grading systems were used: (1) anteroposterior and lateral radiographs (degenerative disk disease) (2) oblique radiographs (facet joint degeneration) (3) macroscopic and (4) microscopic evaluation. The most reliable correlation was between the grading of microscopic findings and the flexibility parameters; the imaging evaluation was not as informative.

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“…9 -11 Therefore, several invasive methods emerged with different reliability, technical difficulties, and, especially, clinical feasibility. For example, invasive methods include conventional lateral radiographs, 3-dimensional lumbar motion analyses by biplanar radiography, 12 videofluoroscopic or cineradiographic analyses, [13][14][15][16] the use of percutaneous transpedicular-external fixation pins 17,18 or Kirschner wires inserted into the spinous process, 19 and the use of open interventional magnetic resonance imaging. 20 Because the specific apparatus required and invasive nature of the aforementioned methods, to date, their use has been limited to scientific studies with small patient series investigated, except for conventional lateral radiographs.…”

mentioning

confidence: 99%

“…Because the postulated main advantage compared to fusion operation is the preservation of mobility, the quantification of movement will be of special clinical interest in future studies dealing with these techniques. Although the demonstration of coupled spinal motion is not possible and the methods are not as precise as other more invasive or technical demanding methods, 12,15,17,19 radiographs obtained in maximum flexion and extension will most likely be used more frequently to calculate the ROM of lumbar spine because of its clinical feasibility. 14,22,24 -28 Different radiologic methods have been described for the analysis of conventional flexion-extension radiographs to calculate the segmental ROM.…”

mentioning

confidence: 99%

Evaluation of Lumbar Spine Motion With Dynamic X-ray–A Reliability Analysis

Cakir

Richter

Käfer

et al. 2006

Spine

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Study Design. Radiologic evaluation of lumbar range of motion (ROM) with dynamic radiograph.Objectives. To calculate 95% confidence intervals (CIs) for the measurement error accompanying different methods, different observers, and different levels of training when measuring sagittal plane segmental ROM in lumbar spine. In addition, to compare the 95% CI with frequently common statistical methods of reliability analysis.Summary of Background Data. Dynamic radiographs are commonly used for ROM calculation of the lumbar spine. Yet, the reliability of different measurement methods still remains unclear.Methods. In 24 patients, levels L4 -L5 and L5-S1 were measured with the Cobb and superimposition methods on flexion-extension radiographs. There were 2 experienced and 1 inexperienced observer that performed the measurements. The 95% CIs were compared with the corresponding Pearson correlation coefficient and P value (t test).Results. The 95% CI of the superimposition method was Ϯ4.0°for the experienced and Ϯ4.7°for the inexperienced observer. The corresponding values for the Cobb method was Ϯ4.2°for the experienced and Ϯ6.8°for the inexperienced observer. The 95% CI for the measurement error became even worse when different methods or observers were compared, whereas a method constancy revealed superior reliability than observer constancy in experienced observers.Conclusions. For lumbar ROM measurement with dynamic radiograph, the superimposition method seems to be more reliable than the Cobb method. Study protocols dealing with ROM measurement have to calculate the 95% CI of the measurement method used because clinically valid conclusions can only be drawn with respect to these intervals.

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A New Technique for Measuring Lumbar Segmental Motion In Vivo

Cited by 80 publications

References 41 publications

Three-dimensional kinematics of the lumbar spine during treadmill walking at different speeds

Three-dimensional kinematics of the lumbar spine during treadmill walking at different speeds

Grading of degenerative disk disease and functional impairment: imaging versus patho-anatomical findings

Evaluation of Lumbar Spine Motion With Dynamic X-ray–A Reliability Analysis

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