Research Article| Volume 14, ISSUE 10, P704-709, December 1999

Lumbar coupling during lateral translations of the thoracic cage relative to a fixed pelvis


      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.
      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.


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        • Junghanns H
        Spondylolishesen Ohne Spalt im Zwischengelenkstuck (“psudolisthesen”).
        Arch Orthop Unfall-Chir. 1930; 29: 118
        • Knutsson F
        The instability associated with disk degeneration in the lumbar spine.
        Acta Radiol. 1944; 25: 593
      1. White AA, Panjabi MM. Clinical biomechanics of the spine. 2nd edition. Philadelphia, PA: Lippincott, 1990

        • Cholewicki J
        • Crisco J.J
        • Oxland T.R
        • Yamamoto I
        • Panjabi M.M
        Effects of posture and structure on three-dimensional coupled rotations in the lumbar spine. A biomechanical analysis.
        Spine. 1996; 21: 2421-2428
        • Panjabi M.M
        • Yamamoto I
        • Oxland T
        • Crisco J
        How does posture affect coupling in the lumbar spine.
        Spine. 1989; 14: 1002-1011
        • Panjabi M.M
        • Oxland T.R
        • Yamamoto I
        • Crisco J.J
        Mechanical behavior of the human lumbar and lumbosacral spine as shown by three-dimensional load–displacement curves.
        J Bone Joint Surg. 1994; 76-A: 413-424
        • Pearcy M.J
        • Tibrewal S.B
        Axial rotation and lateral bending in the normal lumbar spine measured by three-dimensional radiography.
        Spine. 1984; 9: 582-587
        • Willems J.M
        • Jull G.A
        An in vivo study of the primary and coupled rotations of the thoracic spine.
        Clin Biomech. 1996; 11: 311-316
        • Panjabi M.M
        • White A.A
        • Brand R.A
        A note on defining body parts configurations.
        J Biomech. 1974; 7: 385-390
        • Arangio G.A
        • Hartzell S.M
        • Reed J.F
        Significance of lumbosacral list and low-back pain: a controlled radiographic study.
        Spine. 1990; 15: 208-210
      2. Donelson R, Grant W, Kamps C, Metcalf R. Pain response to end-range spinal motion in the frontal plane: a multi-centered, prospective trial. Presented at the International Society for the Study of the Lumbar Spine, Heidelburg, Germany, May 1991

        • Donelson R
        • Aprill C
        • Medcalf R
        • Grant W
        A prospective study of centralization of lumbar and referred pain. A predictor of symptomatic discs and annular competence.
        Spine. 1997; 22: 1115-1122
      3. McKenzie RA. The lumbar spine: Mechanical diagnosis and therapy. Waikanae, New Zealand: Spinal Publications, 1981

        • Porter D.M
        • Miller C.G
        Back pain and trunk list.
        Spine. 1986; 11: 596-600
      4. Waddell G, Main CJ, Morris EW et al. Normality and reliability in the clinical assessment of backache. BMJ 1982;284:1519–23

        • McLean I.P
        • Gillan M.G.C
        • Ross J.C
        • Aspden R.M
        • Porter R.W
        A comparison of methods for measuring trunk list: a simple plumbline is the best.
        Spine. 1996; 21: 1667-1670
        • Khuffash B
        • Porter R.W
        Cross leg pain and trunk list.
        Spine. 1986; 14: 602-603
        • Lorio M.P
        • Bernstein A.J
        • Simmons E.H
        Sciatic spinal deformity – lumbosacral list: an “unusual” presentation with review of the literature.
        J Spinal Disord. 1995; 10: 201-205
        • Capener N
        Alternating sciatic scoliosis.
        Proc R Soc Med. 1933; 24: 426-429
        • Remak E
        Alternirende Scoliose bei Ischias.
        Dtsch Med Wochenschr. 1891; 17: 257-259
        • Grieve G.P
        Treating backache: a topical comment.
        Physiotherapy. 1983; 69: 316
        • Duncan W
        • Hoen T.I
        A new approach to the diagnosis of herniation of the intervertebral disc.
        Surg Gynecol Obstet. 1942; 75: 257-267
        • Panjabi M.M
        • Goel V
        • Oxland T
        • Takata K
        • Duranceau J
        • Krag M
        • Price M
        Human lumbar vertebrae-quantitative three-dimensional anatomy.
        Spine. 1992; 17: 299-306
        • Coleman R.R
        • Bernard B.B
        • Harrison D.E
        The effects of real life x-axis vertebral translation on projected y-axis rotation.
        J Manipulative Physiol Ther. 1998; 21: 333-340
      5. Coleman RR, Bernard BB, Harrison DE. Correlation and quantification of projected 2-dimensional radiographic images with actual 3-dimensional y-axis vertebral rotations. J Manipulative Physiol Ther 1999;22:21–5

        • Perdriolle R
        • Vidal J
        Etude de la courbure scoliotique. Importance de l’extension et de la rotation vertebrale.
        Rev Chir Othop. 1981; 67: 25-34
        • Gunzburg R
        • Gunzburg J
        • Wagner J
        • Fraser R.D
        Radiologic interpretation of lumbar vertebral rotation.
        Spine. 1991; 16: 660-664
        • Panjabi M.M
        • Chang D
        • Dvorak J
        An analysis of errors in kinematic parameters associated with in vivo functional radiographs.
        Spine. 1992; 17: 200-205