1. 1. Quantitative FluoroscopyVsFunctional Radiographyof the lumbar spineFiona MellorResearch RadiographerT: 01202 436280E; imrci.fmellor@aecc.ac.uk
2. 2. Learning outcomesWhy measure intervertebral motion? Sources of errors and variation inflex/ext (functional) radiographsA new adaptation of fluoroscopy(quantitative fluoroscopy - QF)Comparison of radiation dose Novel uses for QF/other studies
3. 3. http://www.aecc.ac.uk/research/imrci
4. 4. Diagnostic categoriesof back pain (CSAG 1994)1% Serious pathology4% Nerve root compression95% Simple (Non-specific) backache- Chemical- Central sensitization- Mechanical (Instability)
5. 5. Why measure intervertebralmotion? DiagnosisTreatment DisabilityResearch
6. 6. Motion Subsystems(Panjabi 1992)PassiveActiveMotorControl
7. 7. In vitro analysis
8. 8. BackWellcome film library. London
9. 9. via the presentIntra and inter subjectvariationIntra and inter examinererrorPositioningDefinition of normal
10. 10. . to the future
11. 11. Passive QuantitativeFluoroscopyAcquisition Image Analysis Output
12. 12. Image analysis
13. 13. Vertebral rotation
14. 14. Inter-vertebral rotation
15. 15. PhDHypothesis: There is a higherprevalence of abnormal mid lumbarinter-vertebral motion patterns in patientswith mechanical LBP compared tocontrols QF passive motion 40 Patients (mechanical CNSLBP) & 40 healthyvolunteers Coronal and sagittal Global range 40o Each direction (Lt Rt, flx, ext)Funded by the NIHR Clinical Academic Training Fellowship
16. 16. Results
17. 17. Abnormal motion patternsMaximum rotation p controls
18. 18. Reference intervalsA definition of abnormal is those whose rotationfalls beyond thatachieved by 95% of thehealthy populationHyper-mobility: p