Affiliations: [a] Clinical Anatomy Research Laboratory, Center for Rehabilitation Research, School of Allied Health Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA | [b] Département d'Anatomie, Université du Québec à Trois-Rivières, Québec, Canada | [c] Department of Physical Therapy, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgium | [d] Research Unit in Osteopathy, Faculté des Sciences de la Motricité, Université Libre de Bruxelles, Bruxelles, Belgium
Correspondence:
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Corresponding author: Stéphane Sobczak, Center for Rehabilitation Research, School of Allied Health Sciences, Texas Tech
University Health Sciences Center, Lubbock, TX, USA. Tel.: +1 806 743 3226; Fax: +1 806 743 6005; E-mail: stephane.sobczak@ttuhsc.edu,
ssobczak@ulb.ac.be
Abstract: BACKGROUND: Stadiometry measures total trunk height variations but
cannot quantify individual spinal segment height changes. Different methods
exist to measure both intervertebral disc and lumbar spine height (LSH)
variations but they are either limited by radiation exposure or cost.
Musculoskeletal ultrasound could be a valuable alternative to measure spinal
segmental height changes as a result of intervention. OBJECTIVE: To validate the use of musculoskeletal ultrasound (MSU)
and new anatomical landmark references used in assessing inter-mammillary
distances (IMD) and LSH changes resulting from lumbar spine traction. METHODS: Two unembalmed cadaveric lumbar spines were extracted to
assess (1) the reliability and validity of MSU, as compared to caliper, for
measuring in vitro IMD and LSH using alternative anatomical landmarks than
previously reported, and (2) the reliability of MSU for measuring in vitro IMD and
lumbar spine height changes recorded during standardized mechanical traction
up to 1.20 cm. RESULTS: Intra- and inter-rater reliability of
musculoskeletal ultrasound for within and between sessions and for all
experimental design, Standard Error ranged from 0.01 to 0.02 and from 0.03
to 0.04 cm for IMDs and LSHs, respectively. Root Mean Square Errors ranged
from 1.6 to 6.8% and from 1 to 1.1% for IMDs and LSHs, respectively
and mean ICC ranged from 0.98 to 1 for LSH. During traction, mean lumbar
spine height measurement change using MSU was 1.15 ± 0.03 cm. Bland and
Altman plots demonstrated confidence intervals included in the limits of
agreement. Nevertheless, there were significant differences (p< 0.001) for
both IMD measurements and lumbar spine height between caliper and ultrasound
measurements. Musculoskeletal ultrasound overestimated distances of about
5.5 ± 1.5%. CONCLUSIONS: Musculoskeletal ultrasound is
reliable and accurate for measuring intersegmental spinal distances and
lumbar spine height with an apparent slight overestimation of distances.
Based on mean differences, ultrasound technology seems to be valid for
measuring lumbar spine height changes and could be suitable for in vivo
research.
