The functional radiographic examination of patients with low-back pain: a study of different forms of variations

Abnormal intervertebral motion has been shown to occur frequently in patients with low-back pain. Various roentgenographic procedures have been used for evaluating normal and abnormal spinal biomechanics. The main aim of this study has been to evaluate the measurement accuracy and the sources of variation in a single-plane functional radiographic study of lumbar intervertebral motion in patients with low-back pain. Analysis of variance was made for intentional and coupled motions in the frontal and sagittal planes, showing least variation in the frontal plane sitting and in the sagittal plane standing. A quantitative reference value of the collective sources of error/variation has been established. Cine-radiographic examinations in the frontal plane were compared with lateral bending roentgenograms to evaluate intermediate stages and extremes of intervertebral motion. A pilot-study was performed indicating that specific manipulative therapy can objectively increase the intersegmental mobility of the lumbar spine.