Abstract
Objective. To determine lumbar coupling during lateral postural translations (lumbosacral list)
of the thoracic cage relative to a fixed pelvis.
Design. Digitized measurements from anteroposterior lumbar radiographs of 17 volunteers were
obtained in neutral, maximal left lateral translation and maximal right lateral translation
posture of the thoracic cage compared to a fixed pelvis. Subjects were constrained
with two sets of clamps at the lateral borders of the pelvis and lower ribs.
Background Data. Clinically, lumbosacral list is a common posture. Range of motion and spinal coupling
results have not been reported for the lumbosacral list movement.
Methods. Four vertebral body corners, mid narrow-waisted body margins, superior and inferior
pedicle margins, and spinous-lamina junction of T12–L5 were digitized on 51 anterior–posterior
lumbar radiographs. Using the orthogonal axes of positive x-direction to the left, vertical as positive y, and anterior as positive z, digitized points were used to measure projected segmental z-axis rotation, y-axis rotation, and segmental lateral translations of each vertebra.
Results. Using the displacement of T12, subjects could translate 35–70 mm left or right along
the x-axis with an average of 53.2 mm to the left and 52.1 mm to the right. Using superior
endplates to superior sacral base, lateral flexion was largest at L1 and decreased
from L1 to L5, but the segmental rotation angles for lateral flexion were largest
at L2–L3 (3.9°), L3–L4 (6.2°) and L4–L5 (5.7°) and were in the same direction as the
main motion translation. The relative z-axis rotation of T12 was opposite to the direction of L1–L5. The coupled y-axis rotations were less than 1° and coupled segmental lateral translations were
averaging less than 1 mm.
Conclusions. Thoracic cage x-axis translations compared to a fixed pelvis are significant, between 35 and 70 mm.
The z-axis lumbar coupled rotation was largest at L2–L3, L3–L4 and L4–L5 and to the same
side of the main motion translation in L1–L5, but opposite the main motion direction
for T12. All other movements were small, averaging less than 1° or 1 mm.
Relevance
The clinically common posture of lateral translation of the thoracic cage (lumbosacral
list) is often associated with disc herniation. Yet normal lumbar coupling patterns
and total range of motion of this movement have not been established in the literature.
Normal values for lumbar segmental coupling on anterior–posterior lumbo-pelvic radiographs
during trunk list might be important for an analysis of segmental instability since
segmental translations were determined to be 1 mm or less.
Keywords
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Article info
Publication history
Accepted:
April 13,
1999
Received:
October 27,
1998
Identification
Copyright
© 1999 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
