Sagittal plane lumbar intervertebral motion during seated flexion-extension radiographs of 658 asymptomatic nondegenerated levels

Staub, Blake N.; Holman, Paul J.; Reitman, Charles A.; Hipp, John A.

doi:10.3171/2015.3.spine14898

Cited by 18 publications

(20 citation statements)

References 34 publications

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“…However, free bending resulted in only approximately 0.5 mm greater translation than controlled bending to 60°. Indeed, the median ranges of translation found in this study, by all of the protocols, compare favourably with those found in a separate study of healthy volunteers 29 . However, although studies of intervertebral translation in back pain patients have concluded that it is related to age and disc height, it does not differentiate patients from controls 17,30,31 .…”

Section: Discussionsupporting

confidence: 86%

Comparison of intra subject repeatability of quantitative fluoroscopy and static radiography in the measurement of lumbar intervertebral flexion translation

Breen

Claerbout

Hemming

et al. 2019

Sci Rep

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Low back pain patients are sometimes offered fusion surgery if intervertebral translation, measured from static, end of range radiographs exceeds 3 mm. However, it is essential to know the measurement error of such methods, if selection for back surgery is going to be informed by them. Fifty-five healthy male (34) and female (21) pain free participants aged 21–80 years received quantitative fluoroscopic (QF) imaging both actively during standing and passively in the lateral decubitus position. The following five imaging protocols were extracted from 2 motion examinations, which were repeated 6 weeks apart: 1. Static during upright free bending. 2. Maximum during controlled upright bending, 3. At the end of controlled upright bending, 4. Maximum during controlled recumbent bending, 5. At the end of controlled recumbent bending. Intervertebral flexion translations from L2-S1 were determined for each protocol and their measurement errors (intra subject repeatability) calculated. Estimations using static, free bending radiographic images gave measurement errors of up to 4 mm, which was approximately twice that of the QF protocols. Significantly higher ranges at L4-5 and L5-S1 were obtained from the static protocol compared with the QF protocols. Weight bearing ranges at these levels were also significantly higher in males regardless of the protocol. Clinical decisions based on sagittal translations of less than 4 mm would therefore require QF imaging.

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Section: Discussionsupporting

confidence: 86%

Comparison of intra subject repeatability of quantitative fluoroscopy and static radiography in the measurement of lumbar intervertebral flexion translation

Breen

Claerbout

Hemming

et al. 2019

Sci Rep

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“…Staub and colleagues reported that, for asymptomatic volunteers, with an age range of 18 to 82 years, the value of sagittal translation at each lumbar segment was: 1.9 mm at L1/L2, 2.4 mm at L2/L3, 2.7 mm at L3/4, 2.8 mm at L4/L5, and 0.5 mm at L5/S1. The sagittal plane rotation ranges were 11.0 • at L1/L2, 12.6 • at L2/L3, 13.3 • at L3/4, 14.7 • at L4/L5, and 12.8 • at L5/S1 [16]. However, there remains a gap in the current clinical knowledge about the range of segmental motion in asymptomatic participants and those with a diagnosis of LI which has not yet been studied.…”

Section: Introductionmentioning

confidence: 93%

Validity of a Screening Tool for Patients with a Sub-Threshold Level of Lumbar Instability: A Cross-Sectional Study

Leungbootnak

Puntumetakul

Kanpittaya

et al. 2021

IJERPH

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Lumbar instability (LI) comprises one subgroup of those with chronic low back pain (CLBP); it indicates the impairment of at least one of the spinal stabilizing systems, and radiographic criteria of translation and rotation are used for its diagnosis. Previous studies have developed and tested a screening tool for LI where patients with sub-threshold lumbar instability (STLI) were detected in the initial stage of lumbar pathology using radiographs as a gold standard for diagnosis. The radiographic measurement in STLI lies between the range of translation and rotation of the LI and asymptomatic lumbar motion. However, there are no studies indicating the validity and cut-off points of the screening tool for STLI. The current study aimed to determine the validity of an LI screening tool to support the diagnostic process in patients with STLI. This study design was cross-sectional in nature. A total of 135 participants with CLBP, aged between 20 and 60 years, who had undergone flexion and extension radiographs, answered a screening tool with 14 questions. The cut-off score for identifying STLI using the screening tool was at least 6/14 positive responses to the LI questions. The findings suggested that the LI screening tool we tested is effective for the detection of STLI. The tool can be used in outpatient settings.

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“…Extension seems to correlate to a smaller translation and range of motion compared to flexion, where most studies describe L5S1 as least mobile. However, those studies reported different sequences and have not described motion patterns of maximum flexion and extension for L1 to S1 due to insufficient fields of view [8][9][10][11][12][13][18][19][20][21][22][23][24][25][26]. Furthermore, all studies described cumulative rotation of each individual segment at specific time points or at specific lumbar ranges of motion, which can result in missing drastic changes in intervertebral rotation between successive frames.…”

Section: Discussionmentioning

confidence: 99%

Lumbar Intervertebral Motion in Healthy Male Participants: Protocol for a Motion Analysis During Flexion and Extension Cinematographic Recordings

Caelers¹,

Boselie²,

Rijkers³

et al. 2020

JMIR Res Protoc

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Background Physiological motion of the lumbar spine is a subject of interest for musculoskeletal health care professionals, as abnormal motion is believed to be related to lumbar conditions and complaints. Many researchers have described ranges of motion for the lumbar spine, but only a few have mentioned specific motion patterns of each individual segment during flexion and extension. These motion patterns mostly comprise the sequence of segmental initiation in sagittal rotation. However, an adequate definition of physiological motion of the lumbar spine is still lacking. The reason for this is the reporting of different ranges of motion and sequences of segmental initiation in previous studies. Furthermore, due to insufficient fields of view, none of these papers have reported on maximum flexion and extension motion patterns of L1 to S1. In the lower cervical spine, a consistent pattern of segmental contributions was recently described. In order to understand physiological motion of the lumbar spine, it is necessary to systematically study motion patterns, including the sequence of segmental contribution, of vertebrae L1 to S1 in healthy individuals during maximum flexion and extension. Objective This study aims to define the lumbar spines’ physiological motion pattern of vertebrae L1, L2, L3, L4, L5, and S1 by determining the sequence of segmental contribution and the sequence of segmental initiation of motion in sagittal rotation of each vertebra during maximum flexion and extension. The secondary endpoint will be exploring the possibility of analyzing the intervertebral horizontal and vertical translation of each vertebra during maximum flexion and extension. Methods Cinematographic recordings will be performed on 11 healthy male participants, aged 18-25 years, without a history of spine problems. Cinematographic flexion and extension recordings will be made at two time points with a minimum 2-week interval in between. Results The study has been approved by the local institutional medical ethical committee (Medical Research Ethics Committee of Zuyderland and Zuyd University of Applied Sciences) on September 24, 2018. Inclusion of participants will be completed in 2020. Conclusions If successful, these physiological motion patterns can be compared with motion patterns of patients with lumbar conditions before or after surgery. Ultimately, researchers may be able to determine differences in biomechanics that can potentially be linked to physical complaints like low back pain. Trial Registration ClinicalTrials.gov NCT03737227; https://clinicaltrials.gov/ct2/show/NCT03737227 International Registered Report Identifier (IRRID) DERR1-10.2196/14741

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Sagittal plane lumbar intervertebral motion during seated flexion-extension radiographs of 658 asymptomatic nondegenerated levels

Cited by 18 publications

References 34 publications

Comparison of intra subject repeatability of quantitative fluoroscopy and static radiography in the measurement of lumbar intervertebral flexion translation

Comparison of intra subject repeatability of quantitative fluoroscopy and static radiography in the measurement of lumbar intervertebral flexion translation

Validity of a Screening Tool for Patients with a Sub-Threshold Level of Lumbar Instability: A Cross-Sectional Study

Lumbar Intervertebral Motion in Healthy Male Participants: Protocol for a Motion Analysis During Flexion and Extension Cinematographic Recordings

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