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Chiropractic Research Review

Changes in the Intervertebral Foramen with Lumbar Motion

Previous studies provide evidence that morphologic changes occur in the intervertebral foramen (IVF) during flexion, extension, lateral bending, and axial rotation of the lumbar spine. Changes in the IVF are important in understanding the pathophysiology of conditions such as foraminal stenosis.

This study examined these overall segmental motion characteristics and correlated these findings with semental motion segments. Eighty-one motion segments were imaged with a computed tomography scanner with 1-mm thick consecutive sections. Each motion was applied with incremental pure moments of flexion, extension, lateral bending, and axial rotation. After application of the last load, the specimens were frozen under load, and computerized tomography was performed using the same technique as before loads were applied.

In total, six parameters of the intervertebral foramen were measured, including: foraminal width (maximum and minimum); foraminal height; disc bulging; thickness of the ligamentum flavum; and cross-sectional area of the foramen. Results showed that:

* Flexion increased foraminal width, height, and area significantly, while decreasing disc bulging and thickness of the ligamentum flavum.

* Extension significantly decreased foraminal width, height, and cross-sectional area.

* On the convex side of lateral bending, foraminal width, height, and area at the opposite side of bending increased and disc bulging significantly decreased. An opposite effect was noted on the concave side of lateral bending.

* Axial rotation on the side of rotation decreased foraminal width and area, while increasing foraminal height and area on the opposite side.

image - Copyright – Stock Photo / Register Mark

Conclusion: The intervertebral foramen of the lumbar spine changed significantly in flexion-extension, lateral bending and axial rotation. Percent change in cross-sectional foraminal area correlated with segmental motion, except for extension motions. Further studies are needed to assess the morphologic changes in the intervertebral foramen in vivo and in the clinical environment.

Fujiwara A, An H, Lim T, Haughton VM. Morphologic changes in the lumbar intervertebral foramen due to flexion-extension, lateral bending, and axial rotation. Spine 2001:26(8), pp876-882.

Chiropractic Research Review

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