{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:08:44Z","timestamp":1787069324276,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U19AR076725\u201001"],"award-info":[{"award-number":["U19AR076725\u201001"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JOR Spine"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic low back pain (cLBP) presents as a heterogeneous condition, making diagnosis and treatment challenging. Lumbar spine intervertebral kinematics may provide an objective assessment of patients with cLBP that may be used to inform treatment decisions and evaluate the efficacy of interventions. The purpose of this study was to provide a quantitative description of intervertebral motion in the lumbar spine during flexion\/extension (F\/E) and lateral bending (LB) in individuals with cLBP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data from 125 individuals is included in this analysis (M: 53; F: 72;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200966\u2009&lt;\u200960\u2009years of age; average BMI: 25.7\u2009\u00b1\u20093.6\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). Dynamic biplane radiography (DBR) and a validated volumetric model\u2010based tracking system were used to assess intervertebral motion at every lumbar level (L1\u2010L2 through L5\u2010S1) during active F\/E and LB movements in individuals with cLBP. The outcome measures were the intervertebral translation and rotation range of motion (ROM), the contribution of each motion segment to lumbar motion, the anterior\u2013posterior slip per degree of flexion (SPDF), and trial\u2010to\u2010trial repeatability as assessed by the standard deviation in continuous kinematics waveforms over 3 trials of each movement. Outcomes were calculated for the entire group as well as for the subgroups of men, women, individuals less than 60\u2009years of age, and individuals 60 or more years of age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean intervertebral F\/E ROM progressively increased from 6.8\u00b0\u2009\u00b1\u20093.1\u00b0 at the L1\u2010L2 through the L4\u2010L5 motion segments, then decreased from 9.7\u00b0\u2009\u00b1\u20095.2\u00b0 at L4\u2010L5 to 8.4\u00b0\u2009\u00b1\u20094.9\u00b0 at L5\u2010S1. However, substantial variability among individuals was observed, and only 7 participants (5.6%) followed this ROM pattern. The mean intervertebral LB ROM increased from 8.8\u00b0\u2009\u00b1\u20093.2\u00b0 at L1\u2010L2 to 9.1\u00b0\u2009\u00b1\u20094.2\u00b0 at L2\u2010L3 and then progressively decreased from the L2\u2010L3 through the L5\u2010S1 motion segments to 2.7\u00b0\u2009\u00b1\u20091.8\u00b0. However, only 13 participants (10.4%) followed this ROM pattern. On average, the L1\u2010L2, L2\u2010L3, and L5\u2010S1 motion segments were the main contributors to F\/E when the torso was near the upright neutral position. L2\u2010L3, L3\u2010L4, and L4\u2010L5 were the main contributors to midrange flexion and extension, and L3\u2010L4, L4\u2010L5, and L5\u2010S1 were the main contributors to lumbar motion when the trunk was near full flexion. L1\u2010L2 and L2\u2010L3 were the main contributors to lumbar LB near the neutral position and through the midrange. The contributions from L4\u2010L5 and L5\u2010S1 peaked at the neutral position and at maximum bending. SPDF was similar in the L1\u2010L2, L2\u2010L3, and L3\u2010L4 motion segments, but less in the L4\u2010L5 motion segment. L5\u2010S1 SPDF was characterized by high variability among individuals as compared to other motion segments. The average trial\u2010to\u2010trial repeatability in intervertebral rotation in the primary plane of motion over all points on the kinematics waveform ranged from 0.3\u00b0 to 0.7\u00b0 across all motion segments during F\/E and LB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates the heterogeneity in lumbar spine intervertebral kinematics in individuals with cLBP. Further research is needed to identify mechanistic links between kinematics and other biological, behavioral, and clinical features in individuals with cLBP and to identify which kinematic characteristics are useful metrics for informing treatment approaches for patients with cLBP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jsp2.70069","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T13:10:36Z","timestamp":1747228236000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Intervertebral Lumbar Spine Kinematics in Chronic Low Back Pain Patients Measured Using Biplane Radiography"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0535-0953","authenticated-orcid":false,"given":"William","family":"Anderst","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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