Literature DB >> 30714007

Patient and radiographer assessment of slump sitting flexion compared to conventional standing forward bending flexion.

Hwee Weng Dennis Hey1, Denise Ai Wen Choong1, Adrian Zhigao Lin1, Eugene Tze-Chun Lau1, Alex Quok An Teo1, Gabriel Liu1, Hee-Kit Wong1.   

Abstract

BACKGROUND: A comparative survey from patients and radiographers of the new slump sitting flexion posture and the conventional standing forward bending posture. This study was performed to compare the technical and logistical aspects of the slump sitting versus the forward bending posture. Slump sitting flexes the lumbar spine more than the forward bending and increases the diagnosis rate of sagittal spinal instability up to 40% depending on the diagnostic criteria used. This should not come at the expense of patient safety and comfort nor burden the radiographers.
METHODS: Sixty patients were recruited from a single tertiary spine centre. Patients were block randomised into two groups with either the forward bending or the slump sitting being performed first. Feedback was obtained through self-administered questionnaires from patients regarding perceived safety, convenience and comfort, plus from radiographers regarding the imaging process, proxy measures of radiographer ability and scan difficulty.
RESULTS: There was no significant difference between the baseline characteristics in both groups. Majority (63%) of patients preferred slump sitting and felt that forward bending caused pain (P=0.025). Overall, slump sitting was equivalent in comfort, perceived safety and ease to forward bending. Despite requiring more logistics (P=0.031), more effort to set up (P=0.002) and explain (P=0.012), the majority of radiographers (83%) preferred slump sitting. This method was felt to be less dangerous (P=0.015) and easier to maintain (P<0.001).
CONCLUSIONS: This study showed that the superiority of slump sitting in allowing more lumbar flexion compared to the forward bending comes with patient safety or comfort. The technical demands of the learning curve can be offset with training. As such, slump sitting flexion views should be adopted as the standardized method for assessing spinal instability.

Entities:  

Keywords:  Lumbar spine; X-rays; dynamic; flexion; instability; questionnaires; slump sitting; spondylolisthesis

Year:  2018        PMID: 30714007      PMCID: PMC6330575          DOI: 10.21037/jss.2018.09.07

Source DB:  PubMed          Journal:  J Spine Surg        ISSN: 2414-4630


  16 in total

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4.  The utility of dynamic flexion-extension radiographs in the initial evaluation of the degenerative lumbar spine.

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5.  Precision measurement of segmental motion from flexion-extension radiographs of the lumbar spine.

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9.  Pain-related fear, lumbar flexion, and dynamic EMG among persons with chronic musculoskeletal low back pain.

Authors:  Michael E Geisser; Andrew J Haig; Agnes S Wallbom; Elizabeth A Wiggert
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10.  Clinical validation of functional flexion-extension roentgenograms of the lumbar spine.

Authors:  J Dvorák; M M Panjabi; J E Novotny; D G Chang; D Grob
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  3 in total

1.  Erratum to patient and radiographer assessment of slump sitting flexion compared to conventional standing forward bending flexion.

Authors: 
Journal:  J Spine Surg       Date:  2019-03

2.  Flexion-extension standing radiographs underestimate instability in patients with single-level lumbar spondylolisthesis: comparing flexion-supine imaging may be more appropriate.

Authors:  Nathan J Lee; Justin Mathew; Jun S Kim; Joseph M Lombardi; Andrew C Vivas; Jay Reidler; Scott L Zuckerman; Paul J Park; Eric Leung; Meghan Cerpa; Mark Weidenbaum; Lawrence G Lenke; Ronald A Lehman; Zeeshan M Sardar
Journal:  J Spine Surg       Date:  2021-03

3.  Seated Lateral X-ray Is a Better Stress Radiograph of the Lumbar Spine Compared to Standing Flexion.

Authors:  J Alex Sielatycki; Tyler Metcalf; Marissa Koscielski; Clinton J Devin; Scott Hodges
Journal:  Global Spine J       Date:  2020-08-04
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