Abstract
Assessment of movements of joints is an important part of their clinical examination. However, movements of the spine are particularly difficult to measure because of its inaccessibility. Normally X-ray measurements are complicated by magnification and distortion, and are restricted to two dimensions. This paper describes the application of the technique of biplanar radiography for measurement of intervertebral movement in the lumbar spine. The positions of nine bony landmarks on each vertebra have been measured in three dimensions. Statistical techniques have been used to obtain a ‘best fit’ of these landmarks in successive radiographic views. Accuracy of measurement has been improved by using the constraint that each vertebra should be a rigid body. The accuracy of the technique has been defined, and it has been used to describe abnormality of intervertebral motion in a group of patients.
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Aho, A., Vartiainen, O. andSalo, O. (1955) Segmentary mobility of the lumbar spine in antero-posterior flexion.Ann. Med. Int. Fenn.,44, 275–285.
Allbrook, D. (1957) Movements of the lumbar spinal column.J. Bone Jt. Surg.,39B, 339–345.
Brown, R. H., Burstein, A. H., Nash, C. L. andSchock, C. C. (1976) Spinal analysis using three-dimensional radiographic technique.J. Biomech.,9, 355–365.
Davidson, M. (1898) Roentgen rays and localisation. An apparatus for exact measurement and localisation by means of roentgen rays.Br. Med. J., 10–14.
Dimnet, J., Fischer, L. P., Gonon, G. andCarret, J. P. (1978) Radiographic studies of lateral flexion in the lumbar spine.J. Biomech.,11, 143–150.
Drerup, B., Frobin, W. andHaeussler, G. (in press). Evaluation of bi-plane radiographs by epipolar ray correlation. Society for Photo-Optical Instrumentation Engineers Proceedings, 166.
Froning, E. C. andFrohman, B. (1954) Motion of the lumbosacral spine after laminectomy and spine fusion. Correlation of motion with the result.J. Bone Jt. Surg.,50A, 897–910.
Frymoyer, J. W., Frymoyer, W. W., Wilder, D. G. andPope, M. H. (1979) The mechanical and kinematic analysis of the lumbar spine in normal living human subjectsin vivo.J. Biomech.,12, 165–172.
Gianturco, C. (1944) A Roentgen analysis of the motion of the lower lumbar vertebrae in normal individuals and patients with low back pain.Am. J. Roentgen.,52, 261–268.
Hagelstam, L. (1949) Retroposition of lumbar vertebrae.Acta Chir. Scand. Suppl., 143.
Keegan, J. J. (1953) Alterations in the lumbar curve related to posture and seating.J. Bone Jt. Surg.,35A, 589–603.
Knutsson, F. (1944) The instability associated with disc degeneration in the lumbar spine.Acta Radiol.,25, 593–609.
Mensor, M. V. andDuvall, T. (1959) Absence of motion at the fourth and fifth lumbar interspaces in patients with and without low back pain.J. Bone Jt. Surg.,41A, 1047–1054.
Miles, M. andSullivan, W. E. (1961) Lateral bending of the lumbar and lumbosacral joints.Anat. Rec.,139, 387–392.
N.A.G. (1977) E04UAF—a computer library package for minimising or maximising a function. Numerical Analysis Group, Oxford, England.
Panjabi, M. M. (1979) Centers and angles of rotation of body joints: a study of errors and optimization.J. Biomech.,12, 911–920.
Panjabi, M. andWhite, A. A. (1971) A mathematical approach for the three dimensional analysis of mechanics of the spine.J. Biomech.,4, 203–211.
Panjabi, M., Brand, R. A. andWhite, A. A. (1976) Three dimensional flexibility and stiffness of the human thoracic spine.J. Biomech.,9, 185–192.
Pennal, G. F., Conn, G. S., McDonald, G., Dale, G. andGarside, H. (1972) Motion studies of the lumbar spine.J. Bone Jt. Surg.,54B, 442–452.
Pope, M. H., Wilder, D. G., Matteri, R. E. andFrymoyer, J. W. (1977) Experimental measurement of vertebral motion under load.Orthop. Clin. N. Amer.,8, 155–167.
Rab, G. T. andChao, E. Y. S. (1977) Verification of roentgenographic landmarks in the lumbar spine.Spine,2, (4), 287–293.
Selvik, G., Olsson, T. H. andWillner, S. (1976). High accuracy analysis of movements of the spine with the aid of roentgen stereophotogrammetric method. InBiomechanics V-B, (Ed.)Komi, P. V., University Park Press, Baltimore, Maryland, USA, 502–507.
Stokes, I. A. F., Wilder, D. G., Frymoyer, J. W. andPope, M. H. (1980) Assessment of patients with low back pain by biplanar radiographic measurement of intervertebral motion. Presented at the 7th annual meeting of the Int. Soc. for Study of the Lumbar Spine, New Orleans, May 1980; to be published inSpine.
Tanz, S. (1953) Motion of the lumbar spine.Am. J. Roentgen.,69, 399–412.
Veress, S. A., Lippert, F. G., Hou, M. C. Y. andTakamoto, T. (1979) Patellar tracking patterns measurement by analytical X-ray photogrammetry.J. Biomech.,12(9) 639–650.
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Stokes, I.A.F., Medlicott, P.A. & Wilder, D.G. Measurement of movement in painful intervertebral joints. Med. Biol. Eng. Comput. 18, 694–700 (1980). https://doi.org/10.1007/BF02443148
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DOI: https://doi.org/10.1007/BF02443148