Slump Sitting X-ray

Abstract

Study Design: This was a prospective study. Purpose: The aim of this study was to introduce a new slump sitting method radiographs and to compare the angular range of motion (ROM) and displacement between conventional flexion view method and slump sitting radiograph. Overview of Literature: Most patients have mechanical low back pain and lumbar instability is considered to be responsible for most chronic and recurrent pain. Dynamic radiographs have been used to identify spinal instability. Methods: After ethics committee permission, this study was initiated. Sixty patients were enrolled in the study after obtaining written informed consent. Patients were randomly allocated into two groups: the first group underwent slump view then conventional view, and the second group underwent conventional view then slump view followed all patient’s extension radiographs taken. Angular and displacement measurements of the lumbar spine were carried out and compared. Results: Of 60 patients, 40 patients and 26 patients were found instability with slump radiographs and conventional flexion radiographs, respectively. When slump and conventional method were compared, the lumbar flexions were larger in slump radiographs. There were 22.35° of additional global flexion (L1/S1) (P < 0.0001) in slump radiographs when compared with conventional radiographs. Greater global flexion using slump method was found at all lumbar segments with L1/L2 contributing 1.15°; P = 0.009, L2/L3 contributing 3.41°; P < 0001, L3/L4 contributing 5.25°; P < 0.001, L4/L5 5.23°; P < 0.001 with the main contributor being L5/S1 7.41°; P < 0001. When slump and conventional method were compared in terms of displacement, there were no significant differences. Conclusion: The slump siting radiographs in lumbar spine instability effectively show the increase in global flexion with significant improvement in segmental flexion. Slump siting radiograph produces more stress in the entire lumbar spine, especially in lower lumbar spine to diagnose lumbar spine instability. Hence, slump sitting dynamic radiograph was shown to be superior to the conventional forward flexion method in measuring the angular ROM and noninferior to the conventional method in the measurement of displacement