Slump sitting X-ray of the lumbar spine is superior to the conventional flexion view in assessing lumbar spine instability

Abstract Background context Flexion radiographs have been used to identify cases of spinal instability. However, current methods are not standardized and are not sufficiently sensitive/specific to identify instability. Purpose Introduction of a new slump sitting method for performing lumbar spine fl...

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Bibliographic Details
Published in:The spine journal 2017-03, Vol.17 (3), p.360-368
Main Authors: Hey, Dennis, MBBS (Sing), MRCS (Ire), MMED (Orth), MCI (Sing), FRCSEd (Orth), FAMS (Orth), Lau, Eugene Tze Chun, MB BChir (Cantab), MRCS (Edin), Lim, Joel-Louis, MBBS (Sing), MRCS (Glasgow), Choong, Denise, BAppSc(Hon) Diagnostic Radiography, Tan, Chuen-Seng, BSc (Hons), MSc, PhD, Liu, Gabriel Ka-Po, MBBCh (Ire), MSc (Ire), FRCS (IRE), FRCSEd (Orth), Wong, Hee-Kit, MBBS (Sing), MMED (Surg), FRCS (Glas), MCh (Orth) Liv, FAMS (Orth)
Format: Article
Language:English
Subjects:
Adult
Aged
Dynamic
Female
Flexion
Humans
Instability
Joint Instability - diagnostic imaging
Joint Instability - physiopathology
Lumbar
Lumbar Vertebrae - diagnostic imaging
Lumbar Vertebrae - physiopathology
Male
Middle Aged
Orthopedics
Posture
Prospective Studies
Range of Motion, Articular
Slump sitting
X-rays
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Summary:Abstract Background context Flexion radiographs have been used to identify cases of spinal instability. However, current methods are not standardized and are not sufficiently sensitive/specific to identify instability. Purpose Introduction of a new slump sitting method for performing lumbar spine flexion radiographs and comparison of the angular range of motions and displacements between the conventional method and this new method. Study design Prospective study on radiologic evaluation of the lumbar spine flexion range of motions and displacements using dynamic radiographs Patient sample 60 patients were recruited from a single spine tertiary centre. Outcomes measured Angular and displacement measurements of lumbar spine flexion Method Participants were randomly allocated into two groups: those who did the new method first, followed by the conventional method; vs those who did the conventional method first, followed by the new method. Comparison of the angular and displacement measurements of lumbar spine flexion between the conventional method and the new method were performed and tested for superiority and non-inferiority. Results The measurements of lumbar angular range of motion were, on average, 17.3° larger (p < 0.0001) using the new slump sitting method compared to the conventional method. They were most significant at the levels of L3L4, L4L5 and L5S1 (p
ISSN:1529-9430
1878-1632
DOI:10.1016/j.spinee.2016.10.003