Three-dimensional in vivo measurement of lumbar spine segmental motion.

Abstract

Fifteen asymptomatic volunteers were externally rotated and CT scanned to determine lumbar segmental motion. To measure three-dimensional segmental motion in vivo using a noninvasive measurement technique. Spinal instability has been implicated as a potential cause of low back pain, especially, axial rotational instability. Typically, flexion-extension lateral radiographs were used to quantify instability, but inaccurately measured translations and inability to capture out-of-plane rotations are limitations. Using a custom-calibrated rotation jig, L1-S1 CT reconstructions were created of volunteers in each of 3 positions: supine and left and right rotations of the torso with respect to the hips. Segmental motions were calculated using Euler angles and volume merge methods in three major planes. Segmental motions were small (< 4 degrees or 6 mm) with the greatest motions seen in axial rotation (range, 0.6 degrees to 2.2 degrees ), lateral bending (range, -3.6 degrees to 3.0 degrees ), and frontal translation (-1.2 mm to 5.4 mm). Largest motions were in the levels: L1-L2 to L3-L4. Complex coupled motions were measured due to external torsion and could be indicative of instability chronic patients with low back pain. The presented data provide baseline segmental motions for future comparisons to symptomatic subjects.