Objectives: The purpose of this study was to assess the use of computer-aided combined movement examination (CME) to measure change in low back movement after neurosurgical intervention for lumbar spondylosis and to use a CME normal reference range (NRR) to compare and contrast movement patterns identified from lumbar disk disease, disk protrusion, and nerve root compression cases.
Methods: A test-retest, cohort observational study was conducted. Computer-aided CME was used to record lumbar range of motion in 18 patients, along with pain, stiffness, disability, and health self-report questionnaires. A minimal clinically important difference of 30% was used to interpret meaningful change in self-reports. z Scores were used to compare CME. Post hoc observation included subgrouping cases into 3 discrete pathologic conditions—disk disease, disk protrusion, and nerve root compression—to report intergroup differences in CME.
Results: Self-report data indicated that 11, 7, and 10 patients improved by ≥30% in pain, stiffness, and function, respectively. Three patients experienced clinically significant improvement in health survey. A CME pattern reduced in all directions suggested disk disease. Unilaterally restricted movement in side-flexed or extended directions suggested posterolateral disk protrusion with or without ipsilateral nerve root compression. Bilateral restrictions in extension suggested posterior disk protrusion with or without nerve root compression. In 11 of the 18 cases, CME converged toward the NRR after surgery.
Conclusion: We described the use of CME to identify atypical lumbar movement relative to an NRR. Data from this short-term postoperative study provide preliminary evidence for CME movement patterns suggestive of disk disease, disk protrusion, and nerve root compression.
Author keywords: Range of Motion, Articular; Spine; Intervertebral Disk; Nerve Compression Syndromes; Neurosurgery
Author affiliations: APM: The Centre for Musculoskeletal Studies, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia; RP: Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth; CRPL: Department of Neurosurgery, Sir Charles Gairdner Hospital, Perth; KS: The Centre for Musculoskeletal Studies, School of Surgery, The University of Western Australia, Perth
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