Kinematic analysis of the lumbar spine by digital videofluoroscopy in 18 asymptomatic subjects and 9 patients with herniated nucleus pulposus

Objectives: The purpose of this study was to use digital videofluoroscopy to identify motion patterns of the lumbar spine during coronal movement in asymptomatic (normal) subjects and patients with herniated nucleus pulposus (HNP). Methods: Videofluoroscopic lumbar coronal motion was recorded in 18 asymptomatic volunteers and 9 patients with HNP. Measurements were made while patients bent laterally and rotated toward the right and left from a sitting position and then returned to their original position. Direction and degree of extension in the coronal plane at each motion segment and sacral descent were measured. Through the motion analysis software, the coupled pattern with lateral bending and rotation was analyzed in the asymptomatic subjects and patients with HNP. Results: Lateral flexion movement was coupled with contralateral extension and ipsilateral sacral descent but with a different rotation pattern. Rotation movement was coupled with ipsilateral extension, ipsilateral sacral descent, and ipsilateral spinous process rotation. Patients with HNP and asymptomatic subjects had similar coupled patterns but differences in amount of motion. Conclusions: Digital videofluoroscopy showed coupled patterns during the lateral bending and rotation movements.