In-vivo motion characteristics of lumbar vertebrae in sagittal and transverse planes

Lumbar vertebrae are complicated in structure and function. The purpose of this study was to investigate the in-vivo motion characteristics of different portions of the lumbar vertebrae during functional activities. Motion of L2, L3 and L4 was reproduced using a combined dual fluoroscopic and MR imaging technique during flexion–extension and left–right twisting of the trunk. The ranges of motion (ROM) of the proximal vertebra with respect to the distal one at 3 representative locations: the center of the vertebral body, the center of the spinal canal and the tip of the spinous process were measured. Centers of rotation (COR) of the vertebrae were then determined by calculation of the points of zero motion in 2D sagittal and transverse planes. During flexion–extension, the center of the vertebral body moved less than 0.6 mm, while the tip of the spinous process moved less than 7.5 mm in the sagittal plane. The CORs of both L23 (L2 with respect to L3) and L34 were located inside the vertebral body, at a distance about one-third the length of the vertebral body from the posterior edge. During left–right twisting, the center of the vertebral body moved less than 1.0 mm, while the tip of the spinous process moved less than 1.6 mm in the transverse plane. The CORs of both L23 and L34 were located approximately 30 mm anterior to the front edge of the vertebral body. The results of this study may be used to define the ideal locations for surgical placement of the disc prosthesis, thus help improve the prosthesis design and surgical treatment of various pathological conditions.