Instability and Low Back Pain

  • Tommy Hansson


At present there are no uniform or generally accepted criteria for the definition of pathological motions, instability between adjacent vertebrae in the human spine. In order to better understand the mechanisms of segmental instability, its kinematics and potential relations to pain we have developed techniques to be used both clinically and experimentally, invasive as well as non-invasive. Invasively through anchoring of a linkage strain gauge system to K-wires rigidly inserted into adjacent spinous processes which has allowed determination of both the range of motion (ROM) and pattern of motion (POM) with high precision. Non-invasively through the use of an optoelectronic device tracking the spine motions from reflectors placed on the spine and the trunk. The kinematic studies have revealed much greater disturbances of the POM than in the ROM. A long-standing muscular contraction and an almost up heaved intervertebral motion was the common but quite surprising finding in subjects with what seemed to be apparent segmental clinical instability (Wessberg et al. (1998) J Spinal Disord 11:163–174). What could be a similar muscle contraction, possibly a “defence musculaire” have been noted also within hours after debut of acute low back pain.


Nucleus Pulposus Disc Degeneration Motion Segment Degenerative Spondylolisthesis Trunk Flexion 
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© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  1. 1.Department of OrthopaedicsSahlgrenska AcademyGöteborgSweden

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