RT Journal
A1 Asghar, Ferhan A.
T1 Commentary on an article by Peter G. Passias, MD, et al.: “Segmental Lumbar Rotation in Patients with Discogenic Low Back Pain During Functional Weight-Bearing Activities”
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2011
FD January 5
VO 93
IS 1
SP e4 1
OP 2
DO 10.2106/JBJS.J.01730
UL http://dx.doi.org/10.2106/JBJS.J.01730
AB 
The study improves on previous work as it was limited to the assessment of patients with pain thought to be primarily discogenic. While degenerative disc disease as a cause of back pain, discography as a diagnostic tool, and spinal surgery as a treatment are all controversial, the authors attempted to streamline patient selection and to correlate symptoms with the limited disc-assessment tools available today: MRI, radiography/fluoroscopy, and discography. Patients with degeneration within the intervertebral disc were characterized according to the Modic and Pfirrmann grading scales. Those with associated facet pathology, neural entrapment, or instability as confounding variables were excluded. Motion was then evaluated in flexion-extension, lateral bending, and axial rotation from L2 through S1. The authors recognized small coupled motions in all three directions associated with movement in any one primary direction. The methodology that was employed for the assessment of range of motion was accurate to within 0.4 mm of translation.