| Assessment of Lumbar Spinal Function by Spinoscope - Clinical Analysis - |
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Jun-Hong Min, M.D., Jung Yul Park, M.D. and Jung-Keun Suh, M.D. |
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Department of Neurosurgery, College of Medicine, Korea University, Korea |
| SpinoscopeⓇ에 의한 요추기능 검사 - 임상 분석 - |
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민준홍, 박정율, 서중근 |
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고려대학교 의과대학 신경외과학교실 |
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| Abstract |
Objective
SpinoscopeⓇ has been introduced as a diagnostic supplemental tool for the assessment of spinal function of which basic concepts were first proposed by Gracovetsky in 1970. Purpose of this study was to evaluate patients with low back pain with or without leg pain using this tool to evaluate its validity in providing better understanding of their functional status related to underlying spinal disorders.
Material and Methods: In this study, a total of 441 patients from outpatient and inpatient department of our hospital complaining of back pain only or back pain with leg pain from June 1998 to May 2003. Average age of patients was 42(range 15-88 years). Male to female ratio was 1.25 to 1. The patients were divided into two groups according to symptoms. Patients complaining of only back pain were included in Group I(76), and patients complaining of back pain and leg pain were assigned to group II(71). According to the protocol, all patients were examined during various movements such as standing, sitting, bending forward and backward as well as sideways under loaded and unloaded situation. These motions were simultaneously detected by infrared camera and obtained data were calculated and analyzed by computer software. These data were then compared to the norms and final results showing segments of functional impairment, types of impaired movements, and overall functionality index were acquired. Finally, these results were compared with radiologic findings and clinical status.
Results
In Group I, mean functionality index was 85% and most common disease entity was back sprain. In Group II, mean functionality index was 79.2% and most common disease entity was herniated intervertebral disc. Interestingly, the patients who showed radiologic abnormalities in MRI, CT, X-ray and functionality index lower than 80% simultaneously were 11.8%, 23.9% in group I, II respectively. This reflects the relatively low chance of radiologic abnormality being coincident with abnormal spinal function as measured by functionality index.
Conclusion
These results indicate that spinal functionality index obtained from SpinoscopeⓇ of our cases are relatively high compared to the degrees of pain that patients had and concomitant radiologic findings. Thus, it is considered a useful and sensitive supportive diagnostic tool for spinal function assessment. It is nonivasive and objective, thus it's application can be merited in many clinical settings, especially on difficult situations where accurate assessment of spinal function is necessary to determine or exclude possible compensation or secondary gain. Also, it will be particularly helpful to determine actual spinal functionality index irrespective of imaging abnormalities which may be coincidentally found.
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| Keywords:
Spinoscope, Spinal function index, Spinal motion, Low back pain, Herniated intervertebral disc |
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