Fluoroscopic Video to Identify Aberrant Lumbar Motion

Teyhen, Deydre S.; Flynn, Timothy W.; Childs, John D.; Kuklo, Timothy R.; Rosner, Michael; Polly, David W.; Abraham, Lawrence D.

doi:10.1097/01.brs.0000259206.38946.cb

Cited by 58 publications

(58 citation statements)

References 53 publications

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“…This research confirms and extends the results of previous studies [8,24,29] that found abnormalities of shared intervertebral motion to be consistent with having CNSLBP and suggests possible mechanisms for this. It also suggests routes for improved understanding of the role of disc degeneration in common back pain in which degeneration may be considered a pain source when it is associated with uneven motion sharing and end-plate signal change.…”

Section: Resultssupporting

confidence: 91%

“…Although its measurement has been generally confined to cadaveric studies, the advancing sophistication of quantitative fluoroscopic systems (QF) is beginning to provide a surrogate in vivo measure in the form of slope of the intervertebral rotation-time curve (also known as the attainment rate) [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…The lumbar spine is a kinetic chain that requires the sharing of motion between levels during bending. Various aspects of intervertebral motion sharing have been investigated in cadaveric studies [17][18][19] in plain radiographic studies in vivo [20][21][22][23][24] and in continuous radiographic studies [3,5,8,20,[25][26][27][28][29][30]. Most of these have studied motion onset and displacement; however, two that studied displacement [4,24] and one that studied pattern variations [29], found differences between patients with CNSLBP and controls.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Uneven intervertebral motion sharing is related to disc degeneration and is greater in patients with chronic, non-specific low back pain: an in vivo, cross-sectional cohort comparison of intervertebral dynamics using quantitative fluoroscopy

Breen

2017

Eur Spine J

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Section: Resultssupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Uneven intervertebral motion sharing is related to disc degeneration and is greater in patients with chronic, non-specific low back pain: an in vivo, cross-sectional cohort comparison of intervertebral dynamics using quantitative fluoroscopy

Breen

2017

Eur Spine J

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“…We calculated t-tests for continuous variables. Continuous variables with p value \ 0.20 were retained for further analysis [37,38]. The more liberal cutoff values were used to preferentially protect against Type II error at this early state of analysis.…”

Section: Discussionmentioning

confidence: 99%

What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study

Teyhen¹,

Shaffer

Butler

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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107

119

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Background Musculoskeletal injury is the most common reason that soldiers are medically not ready to deploy. Understanding intrinsic risk factors that may place an elite soldier at risk of musculoskeletal injury may be beneficial in preventing musculoskeletal injury and maintaining operational military readiness. Findings from this population may also be useful as hypothesis-generating work for particular civilian settings such as law enforcement officers (SWAT teams), firefighters (smoke jumpers), or others in physically demanding professions.Questions/purposes The purposes of this study were (1) to examine whether using baseline measures of self-report and physical performance can identify musculoskeletal injury risk; and (2) to determine whether a combination of predictors would enhance the accuracy for determining future musculoskeletal injury risk in US Army Rangers. Methods Our study was a planned secondary analysis from a prospective cohort examining how baseline factors predict musculoskeletal injury. Baseline predictors associated with musculoskeletal injury were collected using surveys and physical performance measures. Army Physical Fitness Test (consisting of a 2-mile run and 2 minutes of sit-ups and push-ups). A total of 320 Rangers were invited to enroll and 211 participated (66%). Occurrence of musculoskeletal injury was tracked for 1 year using monthly injury surveillance surveys, medical record reviews, and a query of the Department of Defense healthcare utilization database. Injury surveillance data were available on 100% of the subjects. Receiver operator characteristic curves and accuracy statistics were calculated to identify predictors of interest. A logistic regression equation was then calculated to find the most pertinent set of predictors. Of the 188 Rangers (age, 23.3 ± 3.7 years; body mass index, 26.0 ± 2.4 kg/m 2 ) remaining in the cohort, 85 (45.2%) sustained a musculoskeletal injury of interest. Results Smoking, prior surgery, recurrent prior musculoskeletal injury, limited-duty days in the prior year for musculoskeletal injury, asymmetrical ankle dorsiflexion, pain with Functional Movement Screen clearing tests, and decreased performance on the 2-mile run and 2-minute situp test were associated with increased injury risk. Presenting with one or fewer predictors resulted in a sensitivity of 0.90 (95% confidence interval [CI], 0.83-0.95), and having three or more predictors resulted in a specificity of 0.98 (95% CI, 0.93-0.99). The combined factors that contribute to the final multivariable logistic regression equation yielded an odds ratio of 4.3 (95% CI, 2.0-9.2), relative risk of 1.9 (95% CI, 1.4-2.6), and an area under the curve of 0.64. Conclusions Multiple factors (musculoskeletal injury history, smoking, pain provocation, movement tests, and lower scores on physical performance measures) were associated with individuals at risk for musculoskeletal injury. The summation of the number of risk factors produced a highly sensitive (one or less factor) and specific (three o...

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“…Traditional radiographic assessment has some limitations, such as large variation, being based on static postures at extreme ranges of motion and associated large measurement errors [7,[22][23][24][25][26][27]. Therefore, there is a need for tools to assess kinematics in vivo in order to measure the motion characteristics in midrange, where aberrant motion and dysfunction have been postulated to occur, based on neutral zone concept put forth by Panjabi et al [28,29].…”

Section: Introductionmentioning

confidence: 99%

Kinematic analysis of dynamic lumbar motion in patients with lumbar segmental instability using digital videofluoroscopy

et al. 2009

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The study design is a prospective, case-control. The aim of this study was to develop a reliable measurement technique for the assessment of lumbar spine kinematics using digital video fluoroscopy in a group of patients with low back pain (LBP) and a control group. Lumbar segmental instability (LSI) is one subgroup of nonspecific LBP the diagnosis of which has not been clarified. The diagnosis of LSI has traditionally relied on the use of lateral functional (flexion-extension) radiographs but use of this method has proven unsatisfactory. Fifteen patients with chronic low back pain suspected to have LSI and 15 matched healthy subjects were recruited. Pulsed digital videofluoroscopy was used to investigate kinematics of lumbar motion segments during flexion and extension movements in vivo. Intersegmental linear translation and angular displacement, and pathway of instantaneous center of rotation (PICR) were calculated for each lumbar motion segment. Movement pattern of lumbar spine between two groups and during the full sagittal plane range of motion were analyzed using ANOVA with repeated measures design. Intersegmental linear translation was significantly higher in patients during both flexion and extension movements at L5-S1 segment (p \ 0.05). Arc length of PICR was significantly higher in patients for L1-L2 and L5-S1 motion segments during extension movement (p \ 0.05). This study determined some kinematic differences between two groups during the full range of lumbar spine. Devices, such as digital videofluoroscopy can assist in identifying better criteria for diagnosis of LSI in otherwise nonspecific low back pain patients in hope of providing more specific treatment.

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Fluoroscopic Video to Identify Aberrant Lumbar Motion

Abstract: DFV was useful for discriminating between individuals with and without LBP based on kinematic parameters. Disruptions in how the motion occurred during midrange motions were more diagnostic for LBP than range of motion variables. Cross validation of the model is required.

Cited by 58 publications

References 53 publications

Uneven intervertebral motion sharing is related to disc degeneration and is greater in patients with chronic, non-specific low back pain: an in vivo, cross-sectional cohort comparison of intervertebral dynamics using quantitative fluoroscopy

Uneven intervertebral motion sharing is related to disc degeneration and is greater in patients with chronic, non-specific low back pain: an in vivo, cross-sectional cohort comparison of intervertebral dynamics using quantitative fluoroscopy

What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study

Kinematic analysis of dynamic lumbar motion in patients with lumbar segmental instability using digital videofluoroscopy

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