ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Anti-directional segmental motion during flexion and extension in the adolescent thoracolumbar spine: a normative study of 166 participants.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAnti-directional segmental motion has been documented in the cervical spine but never quantified in the thoracolumbar region. We aimed to determine its prevalence and determinants in adolescents and test its independence from coronal deviation.
methodsIdiag M360 data from 166 adolescents (103 males, 63 females; 14.4 ± 0.9 years) were retrospectively analysed. Segmental angles (Th1/2–L5/S1) in upright, flexion and extension were recorded. Anti-directional motion was defined as segmental movement opposite to the intended trunk direction. Bonferroni-corrected correlations, kyphosis tertile analysis, regression and segment-level frontal-plane comparisons were performed (STROBE).
resultsAll 166 participants exhibited anti-directional motion (mean 10.4 ± 2.9 segments). During flexion, 4.0 ± 1.9 segments were affected, almost exclusively thoracic. Thoracic flexion ROM was the dominant determinant (r = − 0.701; regression β = − 1.31, R² = 0.52, adjusted R² = 0.51). A sharp prevalence decline across the lower thoracic spine mapped the rib cage constraint gradient: Th8/9 (39%) → Th11/12 (1.2%), corresponding to the transition from false to floating ribs. Higher kyphosis was associated with more flexion paradox (H = 14.28, p < 0.001), with a threshold near 50°. No association with coronal deviation was found at any thoracic segment (all p > 0.14).
conclusionsAnti-directional segmental motion is a universal feature of adolescent thoracolumbar kinematics. Its distribution maps the rib cage constraint gradient, and its magnitude is governed primarily by thoracic mobility and secondarily by sagittal curvature through an end-range positioning mechanism. These normative data provide a reference framework for future case–control studies investigating segmental motion sharing in adolescent spinal pathology.
Indexed as
Identifiers
42033618What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.