Palpation identification of spinous processes in the lumbar spine

Harlick, Joanne C.; Milosavljevic, Stephan; Milburn, Peter

doi:10.1016/j.math.2006.02.008

Cited by 86 publications

(59 citation statements)

References 19 publications

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“…Accurate identification and marking of bony landmarks in the spine and pelvis has been argued to pose a substantial risk to the between-day reliability of any kinematic measurement [25,43,44,47]. Harlick et al [43] reported 47% accuracy of a manipulative physiotherapist in identifying spinous processes in the lumbar spine, and suggested that marker placement error could reduce the between-day reliability [43]. Therefore, guidelines outlined in previous literature concerned with reliable identification and placement of spinal and pelvic markers were followed in this study [47].…”

Section: Discussionmentioning

confidence: 99%

“…Such systems have been found to be highly accurate and reliable [34,35,[39][40][41], with reported measurement errors of 0.42 degrees for piezoresistive accelerometer [35] and errors ranging between 0.15°and 0.96°f or Fastrack systems [41,42]. Palpation of bony landmarks is however suggested to attribute to a significant source of error during repeated spinal measurements [43,44]. The accuracy of these systems is also affected by the skin movement under the sensor that is unrelated to the vertebral movement, and the sensor's ability to maintain firm apposition during the length of the trial [33,40].…”

Section: Introductionmentioning

confidence: 99%

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Preliminary study: reliability of the spinal wheel. A novel device to measure spinal postures applied to sitting and standing

et al. 2009

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Postural re-education is an integral part of physiotherapy management in patients with back pain. Although the link between posture and back pain is largely unknown, postural re-education is performed on the premise of optimizing spinal alignment to minimize stresses on the passive structures of the spine, to facilitate optimal muscular support and thus to prevent possible damage and further pain. A reliable and clinically meaningful measurement of spinal postures to monitor such interventions remains challenging. This study evaluated within-day (intra-tester, inter-tester) and between-day (test-retest) reliability of a novel spinal wheel device measuring thoracic and lumbar postures during sitting and standing. 17 healthy volunteers (age 39.5 ± 5.4, BMI 25 ± 9.2; 9 males) were measured three times, by three testers, on two separate occasions (1 week apart). The angular change between C7 and T12 and between T12 and S1 provided thoracic and lumbar curvatures, respectively. Intra-class correlation coefficient (ICC) with 95% confidence intervals and typical error were calculated. Excellent reliability was demonstrated with intra-tester ICCs between 0.947 and 0.980 and typical error between 1.7°and 3.7°and intertester ICCs between 0.949 and 0.986 and typical error between 2.0°and 4.7°. Test-retest reliability was high with ICCs 0.719-0.908 and typical error between 4.0°and 7.4°. In conclusion, the spinal wheel demonstrated excellent within-day and high between-day reliability. The device may be used in conjunction with 2D camcorder to provide clinically useful visual evaluation of postures for assessment, intervention monitoring, and feedback during postural re-education.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Preliminary study: reliability of the spinal wheel. A novel device to measure spinal postures applied to sitting and standing

et al. 2009

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“…The shape of these processes can hinder the evaluator when using palpation, because in some participants with severe lumbar lordosis the spinous processes are very close to each other, a fact that frequently leads the evaluator to confuse the end of one lumbar vertebral spinous process with the beginning of another 32 . The excessive subcutaneous fat associated with being overweight can also affect the correct identification of spinous processes in the lumbar region as it hampers palpation of the anatomical structures 33 . This was a factor in the present study, since 75% of participants were women with a BMI of 26.1 (±4.…”

mentioning

confidence: 99%

Validation, repeatability and reproducibility of a noninvasive instrument for measuring thoracic and lumbar curvature of the spine in the sagittal plane

Chaise¹,

Candotti²,

Torre³

et al. 2011

Rev. bras. fisioter.

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“…Accurate estimation of the spinous processes and interspinous spaces between T4 and L2 represents a significant challenge (1). As a result, spine level localization by palpation in posterior approach thoracolumbar spine surgeries may be inaccurate.…”

Section: Introductionmentioning

confidence: 99%

Factors predictive of topographical accuracy in spine level localization

et al. 2017

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Background: Pre-operative spine level localization by palpation of anatomical landmarks (ribs, spinous processes) in posterior approaches for surgeries from T4 to L2 is often inaccurate. This can lead to ineffective utilization of procedural time, increased radiation dose, potentially longer skin incision and wrong level surgery. Factors affecting topographical accuracy includes body mass index (BMI) of the patient, congenital or acquired deformity and knowledge of topographical anatomy.Methods: All patients had the presumed location of their pathology marked on the skin using anatomical landmarks prior to application of the Target Tape ® (Vancouver, BC, Canada) and verification using an anterior-posterior radiograph. Potential factors predictive of accurate pre-operative spine level localization such as age, gender, BMI, palpable deformity, pathology related interspinous distance (ISPD) and pathology related skin to spinous process distance were evaluated.Results: A prospective study was performed with 30 consecutive patients undergoing posterior spine surgery (T4 to L2). Accuracy of pathology related spine level localization using anatomical landmarks was only 40%. Pathology related ISPDs of more than 10 mm and palpable deformity was significantly correlated with successful determination of spine levels using anatomical landmarks.Conclusions: This study showed that poor spine level localization using anatomical landmarks was associated with pathology related ISPDs of less than 10 mm. Conversely, patients with palpable spinal deformity have their levels easily localized.

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Palpation identification of spinous processes in the lumbar spine

Cited by 86 publications

References 19 publications

Preliminary study: reliability of the spinal wheel. A novel device to measure spinal postures applied to sitting and standing

Preliminary study: reliability of the spinal wheel. A novel device to measure spinal postures applied to sitting and standing

Validation, repeatability and reproducibility of a noninvasive instrument for measuring thoracic and lumbar curvature of the spine in the sagittal plane

Factors predictive of topographical accuracy in spine level localization

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