Abstract

AIM: To identify plain radiographic findings that predict segmental lumbar spine instability as shown by functional flexion–extension radiography. MATERIALS AND METHODS: Plain radiographs and flexion–extension radiographs of 215 patients with clinically suspected lumbar spine instability were analysed. Instability was classified into anterior or posterior sliding instability. The registered plain radiographic findings were traction spur, spondylarthrosis, arthrosis of facet joints, disc degeneration, retrolisthesis, degenerative spondylolisthesis, spondylolytic spondylolisthesis and vacuum phenomena. Factors reaching statistical significance in univariate analyses (P<0.05) were included in stepwise multiple logistic regression analysis. RESULTS: Degenerative spondylolisthesis (P=0.004 at L3–4 level andP=0.017 at L4–5 level in univariate analysis and odds ratio 16.92 at L4–5 level in multiple logistic regression analyses) and spondylolytic spondylolisthesis (P=0.003 at L5–S1 level in univariate analyses) were the strongest independent determinants of anterior sliding instability. Retrolisthesis (odds ratio 10.97), traction spur (odds ratio 4.45) and spondylarthrosis (odds ratio 3.20) at L3–4 level were statistically significant determinants of posterior sliding instability in multivariate analysis. CONCLUSION: Sliding instability is strongly associated with various plain radiographic findings. In mechanical back pain, functional flexion–extension radiographs should be limited to situations when symptoms are not explained by findings of plain radiographs and/or when they are likely to alter therapy. Pitkänen, M. T. et al. (2002). Clinical Radiology57, 632–639.

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.