ارزيابي ديناميك حركات ستون فقرات كمري در بيماران مبتلا به بي ثباتي قطعه اي كمري

Dynamic Evaluation ofLumbarSpine Motion in Patients with SegmentalInstability

Objectives: Lumbar segmental instability (LSI) is one subgroup of nonspecific low back pain which its diagnosis has not been clarified. The aim of this study was to present a reliable and nove! method for evaluation of lumbar spine kinematics in sagital plane. Materials & Methods: In this comparative and validity testing study, IS low back pain patients suspected to have LSI and 15 matched healthy subjects were recruited. Pulsed digital video fluoroscopy was used to investigate kinematics of lumbar motion segments during flexion and extension movements. Segmental linear transition and angular di splacement, and Pathway of Center of Rotation (PICR) were calculated for each lumbar motion segment. Movement ~attern oflumbar spine between two groups and during range of motion were compared. Data were analyzed by statistical methods such as: Chi-square, Kolmogroff - Srnirnoff, Independent T test avd ANOVA with repeated measurements. Results: Segmental linear transition was different in patients during both flexion and extension movements at LS-S I segment (P< 0.001). PICR was different in patients for Ll and L5 vertebrae during extension movement (P < 0.001). Six patients s howed "De layed-Seq ue nce" movement pattern and were different from others (P< 0.00 I). Conclusions: Previous studies were unsuccessful to determine differences between LSI patients and healthy subjects. This study determined some differences between two groups during the middle range oflumbar spine. New devices such as digital video fluoroscopy can assist in identifying better criteria to diagnosis of LSI in otherwise nonspecific low back patients in hope of providing more specific treatment.