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A roentgenological evaluation of the relationship between segmental motion and malalignment in lateral bending
1Research Department, Western States Chiropractic College, Portland, OR 97230.
Objective:
A radiographic study was undertaken to determine the relationship between static vertebral malalignment and segmental lumbar motion in lateral bending.
Design:
Survey.
Setting:
Chiropractic college student health center and private chiropractic clinic.
Participants:
249 subjects: 114 with low back pain, 29 asymptomatic with no history and 106 asymptomatic with history. Of these, 194 were freshman volunteers and 55 were new private clinic low back pain patients.
Interventions:
None.
Main Outcome Measures:
Net lumbar segmental tilt and rotation in lateral bending: corrected and uncorrected for segmental malposition with the patient standing in the upright neutral position.
Results:
There was moderate to good negative correlation of malalignment with segmental tilt motion and segmental motion asymmetry (r = -.42 to -.89, p less than .001). Correlation of malalignment with motion from the ideal neutral segmental position of perfect alignment was modest (r = .16-.42). A large variation in segmental motion was found for all segmental malalignments.
Conclusions:
This study suggests that malalignment is associated with segmental tilt motion in lateral bending, although large subject variability greatly compromises predictability on an individual basis. This study also indicates that segmental malposition may complicate the palpation of active range of motion. This is because the malalignment itself may facilitate a greater arc of segmental motion in the direction of comparative restriction in movement from the ideal neutral position to the extreme of lateral flexion.