STUDY DESIGN: Prospective analysis of sagittal vertical axis (SVA) on lateral spine radiographs using 3 different arm positions. OBJECTIVE: To examine whether fists-on-clavicles position represents a functional standing position. SUMMARY OF BACKGROUND DATA: Radiographic visualization of spinal and pelvic sagittal morphology is difficult during relaxed standing because of interference from the arms; however, standing with arms forward-flexed results in a negative shift in SVA. The fists-on-clavicles position was proposed to provide a more functional sagittal profile and adequate visualization of the spine. No existing study compares the SVA between the fists-on-clavicle and relaxed standing positions. METHODS: The SVA was measured on standing lateral radiographs of 14 healthy subjects using 3 different arm positions: relaxed with arms-at-side, arms forward-flexed to 45 degrees (shoulder flexion [SF]), and fists-on-clavicles. RESULTS.: The mean SVA with relaxed standing was 1.4 +/- 1.9 cm. SF produced a significant SVA negative shift (-3.7 +/- 2.3 cm, P < 0.001). The fists-on-clavicle position resulted in a reduced but significant SVA negative shift (-2.3 +/- 2.1 cm, P < 0.001) compared with relaxed standing. CONCLUSION: Although the fists-on-clavicles position was better than SF in reducing the SVA negative shift, a significant negative shift did occur in the fists-on-clavicle position compared with relaxed standing.
STUDY DESIGN: Prospective analysis of sagittal vertical axis (SVA) on lateral spine radiographs using 3 different arm positions. OBJECTIVE: To examine whether fists-on-clavicles position represents a functional standing position. SUMMARY OF BACKGROUND DATA: Radiographic visualization of spinal and pelvic sagittal morphology is difficult during relaxed standing because of interference from the arms; however, standing with arms forward-flexed results in a negative shift in SVA. The fists-on-clavicles position was proposed to provide a more functional sagittal profile and adequate visualization of the spine. No existing study compares the SVA between the fists-on-clavicle and relaxed standing positions. METHODS: The SVA was measured on standing lateral radiographs of 14 healthy subjects using 3 different arm positions: relaxed with arms-at-side, arms forward-flexed to 45 degrees (shoulder flexion [SF]), and fists-on-clavicles. RESULTS.: The mean SVA with relaxed standing was 1.4 +/- 1.9 cm. SF produced a significant SVA negative shift (-3.7 +/- 2.3 cm, P < 0.001). The fists-on-clavicle position resulted in a reduced but significant SVA negative shift (-2.3 +/- 2.1 cm, P < 0.001) compared with relaxed standing. CONCLUSION: Although the fists-on-clavicles position was better than SF in reducing the SVA negative shift, a significant negative shift did occur in the fists-on-clavicle position compared with relaxed standing.
Authors: Dyah Ekashanti Octorina Dewi; Albert G Veldhuizen; Johannes G M Burgerhof; I Ketut Eddy Purnama; Peter M A van Ooijen; Michael H F Wilkinson; Tati Latifah Erawati Rajab Mengko; Gijsbertus Jacob Verkerke Journal: Ann Biomed Eng Date: 2010-05-15 Impact factor: 3.934