A new technique for digital fluoroscopic video assessment of sagittal plane lumbar spine motion.
METHODS
Methodological reliability.


OBJECTIVE
Develop a measurement technique to assess dynamic motion of the lumbar spine using enhanced digital fluoroscopic video (DFV) and a distortion compensated roentgen analysis (DCRA).


BACKGROUND
Controversy over both the definition and consequences of lumbar segmental instability persists. Information from static imaging has had limited success in providing an understanding of this disorder. DFV has the potential to provide further information about lumbar segmental instability; however, the image quality is poor and clinical application is limited.


METHODS
DFV from 20 male subjects (11 with and nine without low back pain) were obtained during eccentric lumbar flexion (30 Hz). Each DFVs was enhanced with a series of filters to accentuate the vertebral edges. An adapted DCRA algorithm was applied to determine segmental angular and linear displacement. Both intraimage and interimage reliability were assessed using intraclass correlation coefficients (ICC) and standard error of the measurement (SEM). RESULTS.: Intraimage reliability yielded an average ICC of 0.986, and the SEM ranged from 0.4-0.7 degrees and 0.2-0.3 mm. Interimage reliability yielded an average ICC of 0.878, and the SEM ranged from 0.7-1.4 degrees and 0.4-0.7 mm.


CONCLUSIONS
Enhanced DFV combined with a DCRA resulted in reliable assessment of lumbar spine kinematics. The error values associated with this technique were low and were comparable to published error measurements obtained when using a similar algorithm on hand-drawn outlines from static radiographs.
Teyhen
Deydre S
DS
U.S. Army-Baylor University Doctoral Program in Physical Therapy, Fort Sam Houston, Houston, Texas 78234, USA. dteyhen@satx.rr.com
Flynn
Timothy W
TW
Bovik
Alan C
AC
Abraham
Lawrence D
LD
D000328:Adult; D000465:Algorithms; D001696:Biomechanical Phenomena / Q000295:instrumentation / Q000379:methods / Q000592:standards; D005471:Fluoroscopy / Q000295:instrumentation* / Q000379:methods* / Q000592:standards; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009068:Movement; D011856:Radiographic Image Enhancement / Q000295:instrumentation / Q000379:methods / Q000592:standards; D015203:Reproducibility of Results