The utility of dynamic flexion-extension radiographs in the initial evaluation of the degenerative lumbar spine.
METHODS
Retrospective radiographic review.


OBJECTIVE
To assess the utility of lateral dynamic flexion-extension radiographs in the initial evaluation of the degenerative lumbar spine.


BACKGROUND
Most surgeons obtain standing anteroposterior (AP) and lateral radiographs in the initial evaluation of patients presenting with lumbar complaints. The potential role of dynamic films in this population has not been established.


METHODS
Of a 390 radiograph series, 342 met inclusion criteria and were reviewed. After assessment of the AP and lateral radiographs, dynamic films were evaluated to determine if additional information was obtained.


RESULTS
Only 2 of the 342 radiographic series had new findings seen on dynamic films not appreciated on the AP and lateral films (a L3-L4 anterolisthesis of 3 mm with flexion and a L5-S1 retrolisthesis of 4 mm with extension). Fifteen additional radiographic series were noted to have a change in the amount of anterolisthesis or retrolisthesis on the dynamic films (changes ranged from 2 to 5 mm).


CONCLUSIONS
In the population studied, dynamic radiographs did not significantly alter the initial course of clinical management beyond standing AP and lateral lumbar images.
Hammouri
Qusai M
QM
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven CT 06520-8071, USA.
Haims
Andrew H
AH
Simpson
Andrew K
AK
Alqaqa
Ahmad
A
Grauer
Jonathan N
JN
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011187:Posture; D011859:Radiography; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*