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Dynamic Angular Three-Dimensional Measurement of Multisegmental Thoracolumbar Motion In Vivo

Gercek, Erol MD*; Hartmann, Frank MD*; Kuhn, Sebastian MD*; Degreif, Jurgen MD, PhD†; Rommens, Pol Maria MD, PhD*; Rudig, Lothar MD, PhD‡

doi: 10.1097/BRS.0b013e31818096ea
Diagnostics

Study Design. Method validation and in vivo motion segment study.

Objective. To determine in healthy subjects in vivo intervertebral segmental kinematics and coupled motion behavior in all 3 planes simultaneously for 3 segments and to evaluate whether these results differ from those in the normal population according to the literature.

Summary of Background Data. Few studies have provided a direct invasive approach to investigate segmental kinematics in vivo. Dynamic recordings of 3-dimensional segmental motion patterns of adjacent segments have rarely been reported. To date, no studies have examined the 3-dimensional segmental movements of the thoracolumbar junction in vivo in detail.

Methods. K-wires were inserted into the Th11, Th12, L1, and L2 spinous processes of 21 healthy subjects. Ultrasound markers and sensors were attached to the k-wires. Real-time motion data were recorded during standardized ranging exercises. Errors caused by the k-wires, and the static and dynamic accuracy of the system, were considered.

Results. Large intersubject variation was found in all of the exercises. The average ranges of motion from Th11 to L2 were 18.7° for flexion-extension, 13.5° for one-sided lateral bending, and 1.8° for one-sided axial rotation. Coupled-motion patterns among the subjects showed a coupled flexion in active lateral bending and a coupled extension in active rotation, but the results were inconsistent for active extension and flexion.

Conclusion. This method offered accurate multisegmental dynamic-recording facilities. The dynamic exercises showed high reproducibility. The ranges of motion for extension/flexion and lateral bending differed from those reported in previous studies. The coupling patterns were only partly consistent because of large interindividual variation. The measurement error was comparable with that of other invasive methods.

The aim of the current study was to determine in healthy subjects in vivo segmental kinematics and coupled motion behavior in all 3 planes simultaneously for 3 segments and to evaluate whether these results differ from those in the normal population according to the literature.

From the *Clinic of Trauma Surgery, Johannes Gutenberg University, Mainz, Germany; †Clinic of Orthopaedics and Trauma Surgery, Staedtische Klinken, Esslingen, Germany; and ‡Clinic of Trauma Surgery, GPR Klinikum, Ruesselsheim, Germany.

Acknowledgment date: December 6, 2007. Revision date: May 4, 2008. Acceptance date: May 6, 2008.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

The manuscript submitted does not contain information about medical device(s)/drug(s). No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Approval given by the ethic commission of the Landesaerztekammer Rheinland-Pfalz, Germany, No. 183701898 (1555).

Address correspondence and reprint requests to Erol Gercek, MD, Clinic of Trauma Surgery, Johannes Gutenberg University of Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; E-mail: gercek@unfall.klinik.uni-mainz.de

© 2008 Lippincott Williams & Wilkins, Inc.