Three-Dimensional X-ray Analysis of Normal Movement in the Lumbar Spine

Pearcy, Mark J.; Portek, Ian; Shepherd, Janis

doi:10.1097/00007632-198404000-00013

Cited by 344 publications

(172 citation statements)

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“…Studies by Pearcy et al [2,6], using biplanar radiography of volunteers in an erect position, have reported smaller segmental ranges of motion in lateral flexion than the current study, but greater ranges at L5-S1 and L1-2. This difference may reflect supine positioning within the confines of the MRI in which the pelvis and lower limbs were stabilised, whilst lateral flexion was induced via shoulder and thoracic spine movement.…”

Section: Discussioncontrasting

confidence: 77%

“…However, a major focus has been on sagittal plane motion, particularly flexion, on the assumption that this represents the most functional lumbar motion [1]. Sagittal motion also contributes to the greatest directional range and is most often implicated as an injuring mechanism [2]. Axial and coronal plane motions, however, are important components of spinal segmental mobility, but have not attracted the same attention in the literature due to the complexities of coupled motion.…”

Section: Introductionmentioning

confidence: 99%

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Nucleus pulposus deformation in response to lumbar spine lateral flexion: an in vivo MRI investigation

Fazey

Takasaki²,

Singer

2010

Eur Spine J

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Whilst there are numerous studies examining aspects of sagittal plane motion in the lumbar spine, few consider coronal plane range of motion and there are no in vivo reports of nucleus pulposus (NP) displacement in lateral flexion. This study quantified in vivo NP deformation in response to side flexion in healthy volunteers. Concomitant lateral flexion and axial rotation range were also examined to evaluate the direction and extent of NP deformation. Axial T2-and coronal T1-weighted magnetic resonance images (MRI) were obtained from 21 subjects (mean age, 24.8 years) from L1 to S1 in the neutral and left laterally flexed position. Images were evaluated for intersegmental ranges of lateral flexion and axial rotation. A novel methodology derived linear pixel samples across the width of the disc from T2 images, from which the magnitude and direction of displacement of the NP was determined. This profiling technique represented the relative hydration pattern within the disc. The NP was displaced away from the direction of lateral flexion in 95/105 discs (p \ 0.001). The extent of NP displacement was associated strongly with lateral flexion at L2-3 (p \ 0.01). The greatest range of lateral flexion occurred at L2-3, L3-4 and L4-5. Small intersegmental ranges of axial rotation occurred at all levels, but were not associated with NP displacement. The direction of NP deformation was highly predictable in laterally flexed healthy lumbar spines; however, the magnitude of displacement was not consistent with the degree of intersegmental lateral flexion or rotation.

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Section: Discussioncontrasting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Nucleus pulposus deformation in response to lumbar spine lateral flexion: an in vivo MRI investigation

Fazey

Takasaki²,

Singer

2010

Eur Spine J

View full text Add to dashboard Cite

show abstract

“…Thus, the patients had flatter and stiffer lumbar spines than normal. The controls showed mean values for ROF lumbar similar to those reported in the literature for healthy individuals assessed using other skin-mounted motion analysis devices [8, 12,34], double inclinometers [36] or X-ray measurements [44], in part confirming the validity of the measures. Whether the reduced ROF lumbar can be attributed entirely to the results of the disc prolapse, or, rather, was also a factor contributing to its development in the first place, cannot be ascertained from the results of this study.…”

Section: Generalsupporting

confidence: 83%

A prospective study of the interrelationship between subjective and objective measures of disability before and 2 months after lumbar decompression surgery for disc herniation

et al. 2005

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“…Moreover, although these proportions were assumed constant during the entire lifting tasks, such may not necessarily be true in vivo as the relative demand at different levels could vary during lifting. These relative ratios were taken from data obtained in static measurements [29,34,76,79], which have also been used in previous dynamic studies [70,82,83] in order to evaluate the contribution of passive tissue in offsetting external load. To prescribe measured rotations in the model, kinematics data of one typical subject rather than the mean of all subjects were considered.…”

Section: Methodological Issuesmentioning

confidence: 99%

“…The total lumbar rotation, calculated as the difference between the foregoing two rotations, was subsequently partitioned in between various segments based on values reported in earlier investigations [3,29,34,76,79,91,104]. Relative proportions of~7, 12,15,22,27 and 17% were used to partition the lumbar rotation between various motion segments from T12 to L5 levels, respectively.…”

Section: Prescribed Posturesmentioning

confidence: 99%

Analysis of squat and stoop dynamic liftings: muscle forces and internal spinal loads

2006

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Despite the well-recognized role of lifting in back injuries, the relative biomechanical merits of squat versus stoop lifting remain controversial. In vivo kinematics measurements and model studies are combined to estimate trunk muscle forces and internal spinal loads under dynamic squat and stoop lifts with and without load in hands. Measurements were performed on healthy subjects to collect segmental rotations during lifts needed as input data in subsequent model studies. The model accounted for nonlinear properties of the ligamentous spine, wrapping of thoracic extensor muscles to take curved paths in flexion and trunk dynamic characteristics (inertia and damping) while subject to measured kinematics and gravity/ external loads. A dynamic kinematics-driven approach was employed accounting for the spinal synergy by simultaneous consideration of passive structures and muscle forces under given posture and loads. Results satisfied kinematics and dynamic equilibrium conditions at all levels and directions. Net moments, muscle forces at different levels, passive (muscle or ligamentous) forces and internal compression/shear forces were larger in stoop lifts than in squat ones. These were due to significantly larger thorax, lumbar and pelvis rotations in stoop lifts. For the relatively slow lifting tasks performed in this study with the lowering and lifting phases each lasting~2 s, the effect of inertia and damping was not, in general, important. Moreover, posterior shift in the position of the external load in stoop lift reaching the same lever arm with respect to the S1 as that in squat lift did not influence the conclusion of this study on the merits of squat lifts over stoop ones. Results, for the tasks considered, advocate squat lifting over stoop lifting as the technique of choice in reducing net moments, muscle forces and internal spinal loads (i.e., moment, compression and shear force).

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Three-Dimensional X-ray Analysis of Normal Movement in the Lumbar Spine

Cited by 344 publications

References 0 publications

Nucleus pulposus deformation in response to lumbar spine lateral flexion: an in vivo MRI investigation

Nucleus pulposus deformation in response to lumbar spine lateral flexion: an in vivo MRI investigation

A prospective study of the interrelationship between subjective and objective measures of disability before and 2 months after lumbar decompression surgery for disc herniation

Analysis of squat and stoop dynamic liftings: muscle forces and internal spinal loads

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