FLEXION-EXTENSION RHYTHM IN THE LUMBOSACRAL SPINE

Study Design and Objectives. This study was conducted to depict the qualitative and quantitative changes of intervertebral rotation and translation from L1-L2 to L5-S1 during flexion, standing, and extension using dynamic lumbosacral radiographs. Methods. A radiopaque ruler was placed on the back of each subject for the normalization of translational value. Eighty-nine volunteers were examined. Results. From extension to flexion, all of the intervertebral rotations approached 0-degrees from the lordotic position; the translations changed from slightly retrolisthetic to zero displacement. Using L3-L4 as a baseline for calculating the intervertebral differences in flexion, all of the rotational differences were less than 1.5-degrees, except at L5-S1, which remained 5-degrees. The mean translational difference was less than 0.6 mm, except at L5-S1, where it remained 1.5 mm. Conclusions. The amount of total flexibility was level-dependent and its frequency distribution is important. Qualitative rhythmic changes from extension to flexion and quantitative values of intervertebral difference in flexion help define the normal flexibility more accurately.