Segmental Instability of the Lumbar Spine

• Published in: Physical therapy Vol. 78; no. 8; pp. 889 - 896
• Main Authors: Fritz, Julie M, Erhard, Richard E, Hagen, Brian F
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01-08-1998
• Subjects: Back; Back pain; Backache; Biomechanical Phenomena; Humans; Joint Instability - diagnosis; Joint Instability - physiopathology; Joint Instability - rehabilitation; Low Back Pain - physiopathology; Low Back Pain - rehabilitation; Lumbar vertebrae; Lumbar Vertebrae - physiology; Pain; Physical therapy; Physical Therapy Modalities; Physiological aspects; Range of Motion, Articular - physiology; Spine; Vertebrae, Lumbar
• ISSN: 0031-9023; 1538-6724
• DOI: 10.1093/ptj/78.8.889

JM Fritz, PT, ATC, is Assistant Professor, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, 6035 Forbes Tower, Pittsburgh, PA 15260 (USA) ([e-mail]).
RE Erhard, DC, PT, is Assistant Professor, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, and Director of Physical Therapy and Chiropractic Services, Spine Specialty Center, University of Pittsburgh Medical Center, Pittsburgh, Pa.
BF Hagen, PT, is Clinical Assistant Professor, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, and Director of Outpatient Orthopaedic Rehabilitation, CORE Network, Pittsburgh, Pa.
This excerpt was created in the absence of an abstract.
Low back pain (LBP) is a pervasive problem in modern societies, but identifying a specific pathoanatomical cause is not possible in a majority of cases. 1 Patients for whom a specific pathoanatomical diagnosis cannot be made are often described as having "mechanical" LBP. Many researchers and clinicians suggest that segmental instability of the lumbar spine is a possible pathomechanical mechanism underlying mechanical LBP. 1–3 Segmental instability of the lumbar spine, however, remains a controversial and poorly understood topic. 4 The purpose of this update is to review the current literature on segmental instability of the lumbar spine, with special emphasis on Panjabi's theory of the "neutral zone" and how that relates to physical therapy.
Basic Biomechanics of the Lumbar Spine
The lumbar spine, although often described as a single functional unit, is composed of 5 vertebrae forming what are called "motion segments" connected in series. 5 ...
Key Words: Back • Pain • Spine • Trunk
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