Rotational instability of the mid-thoracic spine: assessment and management

SUMMARY. Recent research has enhanced the understanding of instability of the spine. The principles of this research have been incorporated into the evaluation and treatment of the unstable thorax. Rotational instability of the midthorax is commonly seen following trauma to the chest. Specific mobility and stability tests have been developed to detect this instability. The tests are derived from a biomechanical model of evaluation. Treatment is based on sound stabilization principles and although the segment will remain unstable on passive testing, the patient can be trained to control the biomechanics of the thorax and return to a high level of function. Copyright 1996 Harcourt Publishers Ltd.