Relationship between pain and intersegmental spinal motion characteristics in low-back pain subjects

This study was undertaken to determine the relationship between low-back pain and spinal motion. Percutaneous intra-pedicle screws were placed into the right and left L4 (or L5) and S1 segments of nine chronic low-back pain patients. Each of the subjects performed a standard battery of spinal motions including bending in all planes. At the completion of each desired motion, each subject was asked to self-report the pain they experienced on a 10 point scale. The 3D location of markers attached to the pedicle screws was recorded for each motion. Intra- and inter-vertebral motions were calculated. The time series data was reduced to the ranges of motion for each of the tests. A three-layer neural network with fast back-propagation learning algorithm was designed to investigate the relationship between the pain and the motion parameters. This model provided an accurate model for prediction of low-back pain from segmental spinal motion and also offered insights into the mechanisms causing mechanical low-back pain.