Comparison of intra subject repeatability of quantitative fluoroscopy and static radiography in the measurement of lumbar intervertebral flexion translation

Breen, Alexander, Claerbout, Emilie, Hemming, Rebecca ORCID: https://orcid.org/0000-0002-8708-5638, Ayer, Ravi and Breen, Alan 2019. Comparison of intra subject repeatability of quantitative fluoroscopy and static radiography in the measurement of lumbar intervertebral flexion translation. Scientific Reports 9 , 19253. 10.1038/s41598-019-55905-1

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Abstract

Low back pain patients are sometimes offered fusion surgery if intervertebral translation, measured from static, end of range radiographs exceeds 3 mm. However, it is essential to know the measurement error of such methods, if selection for back surgery is going to be informed by them. Fifty-five healthy male (34) and female (21) pain free participants aged 21–80 years received quantitative fluoroscopic (QF) imaging both actively during standing and passively in the lateral decubitus position. The following five imaging protocols were extracted from 2 motion examinations, which were repeated 6 weeks apart: 1. Static during upright free bending. 2. Maximum during controlled upright bending, 3. At the end of controlled upright bending, 4. Maximum during controlled recumbent bending, 5. At the end of controlled recumbent bending. Intervertebral flexion translations from L2-S1 were determined for each protocol and their measurement errors (intra subject repeatability) calculated. Estimations using static, free bending radiographic images gave measurement errors of up to 4 mm, which was approximately twice that of the QF protocols. Significantly higher ranges at L4-5 and L5-S1 were obtained from the static protocol compared with the QF protocols. Weight bearing ranges at these levels were also significantly higher in males regardless of the protocol. Clinical decisions based on sagittal translations of less than 4 mm would therefore require QF imaging.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Healthcare Sciences
Additional Information:	This article is distributed under the terms of the Creative Commons Attribution 4.0 International License
Publisher:	Nature Publishing Group
ISSN:	2045-2322
Date of First Compliant Deposit:	12 December 2019
Date of Acceptance:	2 December 2019
Last Modified:	05 May 2023 08:21
URI:	https://orca.cardiff.ac.uk/id/eprint/127630

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