Lumbosacral kinematics in the sagittal plane: a radiographic study in vivo

Lateral functional radiographs of flexion and extension using Putto's method were examined in 89 normal subjects. A specially-designed radiopaque ruler was placed on each film for calibration. A computer-assisted method was used for digitization and analysis. There were weak negative correlations between age and range of motion, especially at the L4-L5 level (r = 0.437). No significant correlation was noted between age and translation. For flexion-extension rotation, although large variations may limit its usefulness in judging instability in some clinical settings, the data still provide a good diagnostic basis. For translation changes, 2 mm is regarded as acceptable in most cases at levels from L1 to L5, but not at the level of L5-S1 where the average translation change was only 0.4 mm. The differences in the absolute translation value among different positions were not statistically significant (p = 0.064).