{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:16:45Z","timestamp":1787019405564,"version":"build-2736575974"},"reference-count":18,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T00:00:00Z","timestamp":1596499200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Prospective lumbar radiograph analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To compare changes in lumbar lordosis in standing flexion versus seated lateral radiographs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Standing lateral, standing flexion, and seated lateral X-rays of the lumbar spine were obtained in patients presenting with low back pain. Trauma, tumor, and revision cases were excluded. Changes in global lumbar as well as segmental lordosis were measured in each position.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Seventy adult patients were reviewed. Overall, the greatest changes in lordosis were seen at L4-S1 in both the seated and flexion X-rays (12.5\u00b0 and 6.3\u00b0, respectively). Greater kyphosis was seen in seated versus flexion X-rays (21.6\u00b0 vs 15.8\u00b0); changes in lordosis from L1-L3 were similar in both positions, with little change seen at these levels (approximately 5\u00b0 to 7\u00b0). On subgroup analysis, these differences were magnified in analyzing only patients that moved at least 20\u00b0 globally, and there were no significant differences between sitting and flexion in \u201cstiff\u201d patients that moved less than 20\u00b0 globally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Greater lumbar kyphosis was seen in the seated position compared to standing flexion, especially from L4-S1. Given these results we suggest the use of seated lateral X-rays to dynamically assess the lumbar spine. These findings may also guide future research into the mechanism and clinical relevance of a stiff versus mobile lumbar spine, as well as into the sensitivity of seated X-rays in detecting instability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2192568220939527","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T06:33:38Z","timestamp":1596522818000},"page":"1099-1103","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Seated Lateral X-ray Is a Better Stress Radiograph of the Lumbar Spine Compared to Standing Flexion"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3432-5052","authenticated-orcid":false,"given":"J. Alex","family":"Sielatycki","sequence":"first","affiliation":[{"name":"Center for Sports Medicine and Orthopedics, Chattanooga Orthopedic Group, Chattanooga, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Metcalf","sequence":"additional","affiliation":[{"name":"The Ohio State University, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marissa","family":"Koscielski","sequence":"additional","affiliation":[{"name":"3Spine SEZC, Duxbury, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clinton J.","family":"Devin","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Nashville, TN, USA"},{"name":"Steamboat Orthopedic and Spine Institute, Steamboat Springs, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Hodges","sequence":"additional","affiliation":[{"name":"Center for Sports Medicine and Orthopedics, Chattanooga Orthopedic Group, Chattanooga, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,8,4]]},"reference":[{"key":"bibr1-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199105000-00014"},{"key":"bibr2-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2016.03.056"},{"key":"bibr3-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2009.11.008"},{"key":"bibr4-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2010.06.005"},{"key":"bibr5-2192568220939527","doi-asserted-by":"publisher","DOI":"10.3171\/2014.1.FOCUS13551"},{"key":"bibr6-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1007\/s00776-012-0281-1"},{"key":"bibr7-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2013.07.464"},{"key":"bibr8-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1111\/joa.12451"},{"key":"bibr9-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2016.10.003"},{"key":"bibr10-2192568220939527","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2018.09.07"},{"key":"bibr11-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2016.08.026"},{"key":"bibr12-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-007-0401-3"},{"key":"bibr13-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1002\/ar.23559"},{"key":"bibr14-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2004.07.007"},{"key":"bibr15-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-009-0947-3"},{"key":"bibr16-2192568220939527","first-page":"27","volume":"230949901984237","author":"Bagheri SR","year":"2019","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"bibr17-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-014-3454-0"},{"key":"bibr18-2192568220939527","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199503010-00004"}],"container-title":["Global Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2192568220939527","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2192568220939527","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2192568220939527","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:19:09Z","timestamp":1777447149000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2192568220939527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,4]]},"references-count":18,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1177\/2192568220939527"],"URL":"https:\/\/doi.org\/10.1177\/2192568220939527","relation":{},"ISSN":["2192-5682","2192-5690"],"issn-type":[{"value":"2192-5682","type":"print"},{"value":"2192-5690","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,4]]}}}