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  • Title: The utility of dynamic flexion-extension radiographs in the initial evaluation of the degenerative lumbar spine.
    Author: Hammouri QM, Haims AH, Simpson AK, Alqaqa A, Grauer JN.
    Journal: Spine (Phila Pa 1976); 2007 Oct 01; 32(21):2361-4. PubMed ID: 17906579.
    Abstract:
    STUDY DESIGN: Retrospective radiographic review. OBJECTIVE: To assess the utility of lateral dynamic flexion-extension radiographs in the initial evaluation of the degenerative lumbar spine. SUMMARY OF BACKGROUND DATA: Most surgeons obtain standing anteroposterior (AP) and lateral radiographs in the initial evaluation of patients presenting with lumbar complaints. The potential role of dynamic films in this population has not been established. METHODS: Of a 390 radiograph series, 342 met inclusion criteria and were reviewed. After assessment of the AP and lateral radiographs, dynamic films were evaluated to determine if additional information was obtained. RESULTS: Only 2 of the 342 radiographic series had new findings seen on dynamic films not appreciated on the AP and lateral films (a L3-L4 anterolisthesis of 3 mm with flexion and a L5-S1 retrolisthesis of 4 mm with extension). Fifteen additional radiographic series were noted to have a change in the amount of anterolisthesis or retrolisthesis on the dynamic films (changes ranged from 2 to 5 mm). CONCLUSION: In the population studied, dynamic radiographs did not significantly alter the initial course of clinical management beyond standing AP and lateral lumbar images.
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