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Segmental motion and instability.

I A Stokes1, J W Frymoyer

  • 1Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington.

Spine
|September 1, 1987
PubMed
Summary
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Biplanar radiography showed reduced motion at symptomatic lumbar spine levels, but this method was not useful for diagnosing degenerative instability. Further research is needed for accurate diagnosis.

Area of Science:

  • Orthopedics
  • Spine Surgery
  • Radiology

Background:

  • Degenerative instability of the lumbar spine affects many patients.
  • Accurate diagnosis is crucial for effective treatment.

Purpose of the Study:

  • To evaluate the utility of biplanar radiography in diagnosing lumbar spine instability.
  • To compare measured spinal motion with clinical symptoms and radiologic findings.

Main Methods:

  • Seventy-eight patients with suspected lumbar instability were assessed.
  • Biplanar radiography measured intersegmental motion during flexion and extension.
  • Motion components were compared with clinical symptoms and facet joint injections.

Main Results:

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  • Symptomatic lumbar spine levels showed slightly less flexion and anteroposterior (AP) shear motion compared to nonsymptomatic levels.
  • AP shear motion was generally less than 3 mm.
  • A positive correlation was found between forward shear motion and flexion motion (r = 0.3).
  • The shear-flexion ratio was significantly reduced at symptomatic levels.

    • Conclusions:

    • While a tendency toward abnormal intersegmental motion was observed, flexion-extension biplanar radiography proved ineffective for diagnosing lumbar instability.
    • Further diagnostic methods are required for lumbar instability.