Variability in Flexion Extension Radiographs of the Lumbar Spine: A Comparison of Uncontrolled and Controlled Bending

Boyle Cheng; Anthony E. Castellvi; Reginald J. Davis; David C. Lee; Morgan P. Lorio; Richard E. Prostko; Chip Wade

doi:10.14444/3020

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Table 1
Participant Demographics.
Asymptomatic (n = 57) Symptomatic (n = 52) Difference
Mean Std Dev Mean Std Dev Mean Std Dev
Age (yrs) 48 11 53 13 5 2
Height (in) 65.6 6.1 63.8 6.4 1.8 0.3
Weight (lbs) 168 29 176 32 8 3
BMI (lbs/in²) 26.6 4.7 30.2 4.9 3.6 0.2

Panel A. Columns I-III report means and standard deviations of intervertebral rotation by level in asymptomatic individuals; columns IV-V report the differences in means and standard deviations of intervertebral rotation by level.

	[I]		[II]		[III]		[IV]		[V]
	SBR		VMA (Standing)		VMA (Lying)		Δ SBR-VMA (Standing)		Δ SBR-VMA (Lying)
Level	Mean	Std Dev	Mean	Std Dev	Mean	Std Dev	Mean	Std Dev	Mean	Std Dev
L1-L2	7.6	4.3	8.6	3.6	5.9	2.3	1.0	0.7	1.7^**	2^***
L2-L3	11.2	4.8	10.1	3.7	6.8	2.4	1.1	1.1^**	4.4^***	2.4^***
L3-L4	10.1	5.1	9.2	4.1	7.7	2.6	0.9	1^**	2.4^***	2.5^***
L4-L5	11.9	7.1	8.3	4.4	9.1	3.3	3.6^**	2.7^***	2.8^***	3.8^***
L5-S1	8.1	6.2	10.3	4.6	8.5	4.2	-2.2^*	1.6^***	-0.4	2^**
Average	9.8	5.5	9.3	4.1	7.6	3.0	0.5	1.4^**	2.2^***	2.5^***

Panel B. Columns I-III report means and standard deviations of intervertebral rotation by level in symptomatic individuals; columns IV-V report the differences in means and standard deviations of intervertebral rotation by level.

	[I]		[II]		[III]		[IV]		[V]
	SBR		VMA (Standing)		VMA (Lying)		Δ SBR-VMA (Standing)		Δ SBR-VMA (Lying)
Level	Mean	Std Dev	Mean	Std Dev	Mean	Std Dev	Mean	Std Dev	Mean	Std Dev
L1-L2	6.7	4.8	6.4	3.3	5.4	2.4	0.3	1.5^**	1.3^*	2.4^***
L2-L3	7.1	5.0	8.9	3.1	6.2	2.3	-1.8^*	1.9^***	0.9	2.7^***
L3-L4	7.6	5.5	10.0	3.7	6.9	2.5	-2.4^*	1.7^**	0.7	3.0^***
L4-L5	6.8	6.2	9.3	3.0	8.7	3.1	-2.5^**	3.2^***	-1.9^*	3.1^***
L5-S1	7.4	4.7	3.8	2.1	7.9	4.3	3.6^**	2.6^***	-0.5	0.5
Average	7.1	5.2	7.7	3.1	7.0	2.9	-0.6	2.2^***	0.1	2.3^***

↵* p < 0.1
↵** p < 0.05
↵*** p < 0.01

	[I]		[II]		[III]		[IV]		[V]
	SBR		VMA (Standing)		VMA (Lying)		Δ SBR-VMA (Standing)		Δ SBR-VMA (Lying)
Level	Mean	Std Dev	Mean	Std Dev	Mean	Std Dev	Mean	Std Dev	Mean	Std Dev
L1-L2	6.5	4.2	8.1	2.9	6.2	2.3	-1.6^**	1.3^***	0.3	1.9^***
L2-L3	9.7	4.6	9.6	2.8	9.0	2.2	0.1	1.8^***	0.7	2.4^***
L3-L4	10.2	4.6	10.1	3.2	9.8	2.9	0.1	1.4^***	0.4	1.7^***
L4-L5	7.2	4.2	8.6	3.8	9.2	3.2	-1.4^**	0.4	-2^***	1^**
L5-S1	1.9	1.6	3.1	1.6	3.8	2.2	-1.2^*	0.0	-1.9^**	-0.6
Average	7.1	3.8	7.9	2.9	7.6	2.6	-0.8	1.0^***	-0.5	1.3^***

	[I]		[II]		[III]		[IV]		[V]
	SBR		VMA (Standing)		VMA (Lying)		Δ SBR-VMA (Standing)		Δ SBR-VMA (Lying)
Level	Mean	Std Dev	Mean	Std Dev	Mean	Std Dev	Mean	Std Dev	Mean	Std Dev
L1-L2	5.7	3.8	8.0	3.0	7.0	2.4	-2.3^**	0.8^*	-1.3^*	1.4^**
L2-L3	7.8	4.1	9.7	2.8	8.4	2.7	-1.9^*	1.3^**	-0.6	1.4^**
L3-L4	9.4	4.7	10.4	3.2	9.1	3.1	-1.0	1.5^**	0.3	1.6^***
L4-L5	6.9	3.8	8.5	3.8	8.2	2.5	-1.6^*	0.0	-1.3^*	1.3^**
L5-S1	2.4	1.3	2.9	1.4	3.9	2.8	-0.5 -	0.1	-1.5^*	1.5^**
Average	6.4	3.5	7.9	2.8	7.3	2.7	-1.5^*	0.7^*	-0.9	1.4^**

↵* p < 0.1
↵** p < 0.05
↵*** p < 0.01

Panel A. % change in flexion/extension bending

	% Change: VMA (Standing)/SBR		% Change: VMA (Lying)/SBR
Level	Mean	Std Dev	Mean	Std Dev
L1-L2	13%	-16%	-22%	-47%
L2-L3	-10%	-23%	-39%	-50%
L3-L4	-9%	-20%	-24%	-49%
L4-L5	-30%	-38%	-24%	-54%
L5-S1	27%	-26%	5%	-32%
Average	-5%	-26%	-22%	-46%

Panel B. % change in left/right lateral bending

	% Change: VMA (Standing)/SBR		% Change: VMA (Lying)/SBR
Level	Mean	Std Dev	Mean	Std Dev
L1-L2	25%	-31%	-5%	-45%
L2-L3	-1%	-39%	-7%	-52%
L3-L4	-1%	-30%	-4%	-37%
L4-L5	19%	-10%	28%	-24%
L5-S1	63%	0%	100%	38%
Average	11%	-26%	7%	-33%

Panel A. % change in flexion/extension bending.

	% Change: VMA (Standing)/SBR		% Change: VMA (Lying)/SBR
Level	Mean	Std Dev	Mean	Std Dev
L1-L2	-5%	-31%	-19%	-50%
L2-L3	25%	-38%	-12%	-54%
L3-L4	32%	-31%	-9%	-54%
L4-L5	37%	-51%	27%	-49%
L5-S1	-49%	-56%	7%	-10%
Average	8%	-41%	-1%	-44%

Panel B. % change in left/right lateral bending

	% Change: CCBR (Standing)/SBR		% Change: CCBR (Lying)/SBR
Level	Mean	Std Dev	Mean	Std Dev
L1-L2	40%	-21%	23%	-36%
L2-L3	25%	-31%	8%	-34%
L3-L4	11%	-33%	-3%	-35%
L4-L5	23%	-1%	19%	-35%
L5-S1	21%	5%	62%	116%
Average	23%	-20%	14%	-24%