Asian Spine J.  2015 Oct;9(5):770-775. 10.4184/asj.2015.9.5.770.

Relative Contribution of Upper and Lower Lumbar Spinal Segments to Flexion/Extension: Comparison between Normal Spines and Spines with Disc Disease in Asian Patients

• Bali T
• Kumar MN

• KMID: 2148373
• DOI: http://doi.org/10.4184/asj.2015.9.5.770

Abstract

STUDY DESIGN: Prospective cohort study. PURPOSE: To evaluate the contribution of upper and lower lumbar segments to flexion and extension of the lumbar spine in normal and diseased spines. OVERVIEW OF LITERATURE: The specific contributions of upper and lower lumbar segments during flexion/extension have rarely been reported. Furthermore, no comparisons between the flexion/extension behaviors of normal and diseased spines have been reported until now.
METHODS
Flexion and extension lateral radiographs of 52 adult, asymptomatic volunteers, and 67 adult patients with lumbar spine disc disease were measured using software for total lumbar lordosis, upper lumbar lordosis and lower lumbar lordosis and the intervertebral angles of all segments.
RESULTS
In asymptomatic volunteers, the range of movement between flexion and extension was a mean of only 4.2degrees in the lower lumbar spine and a mean of 19.4degrees in the upper lumbar spine. In patients with disc degeneration, the range of movement between flexion and extension was an average 6.5degrees for lower lumbar spine and 15.6degrees for the upper lumbar spine.
CONCLUSIONS
The results showed that upper lumbar spine contributes more to the range of motion in flexion and extension than the lower lumbar spine in asymptomatic individuals without lumbar disc disease, as well as in patients with disc degeneration.

Keyword

Lordosis; Lumbar vertebrae; Lumbosacral region; Intervertebral disc degeneration; Intervertebral disc disease

MeSH Terms

Adult
Animals
Asian Continental Ancestry Group*
Cohort Studies
Humans
Intervertebral Disc Degeneration
Lordosis
Lumbar Vertebrae
Lumbosacral Region
Prospective Studies
Range of Motion, Articular
Spine*
Volunteers