Lumbar instability: a dynamic approach by traction-compression radiography.
Translatory segmental instability was provoked by successive axial traction and compression of the lumbar spine in 117 patients with a known spondyl- or retro-olisthetic displacement. Lateral spot radiography showed an anteroposterior translatory movement of 5 mm or more in 24 of 45 patients with lytic spondylolisthesis of L5, in all of 7 patients with degenerative spondylolisthesis of L4, and in 37 of 65 patients with a retro-olisthetic displacement of L3, L4, or L5. In cases of spondyl- and retro-olisthetic instability the upper vertebra moved posteriorly during traction and anteriorly during compression. Severity of low-back pain (LBP) symptoms did not show any correlation with the degree of the maximal displacement but correlated significantly with the amount of instability both in the case of spondyl- and retro-olisthesis. Traction-compression radiography proved a simple and practical method to diagnose and measure translatory segmental instability even when conventional flexion-extension load failed to provoke any abnormal movement (eg, in the case of spondylolisthesis).
D000293:Adolescent; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000503:physiopathology; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008141:Lordosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009068:Movement; D011187:Posture; D011859:Radiography; D013122:Spinal Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000503:physiopathology; D013169:Spondylolysis / Q000000981:diagnostic imaging / Q000503:physiopathology; D014143:Traction