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Published Studies

Below is a summary of published articles related to the KineGraph VMA technology.

The KineGraph VMA technology

  • Lorio M, Butterworth K, Deitz AK. In Vivo Analysis of Intervertebral Kinematics: Differences between Standing Active and Recumbent Passive Bending Modes. SAS Poster Exhibit. 2010.
    Download poster handout (PDF - opens new window)
  • Mellor FE, Muggleton JM, Bagust J, Mason W, Thomas PW, Breen AC. Midlumbar lateral flexion stability in healthy volunteers by in vivo fluoroscopy. Spine. 2009; 34(22):E811-E817
  • Breen A, Mellor F, Fowler J. Adjacent segment motion and posterior lumbar spine instrumentation: a comparison of patient groups. Spine Arthroplasty Society. Global Symposium on Motion Preservation Technology. 2007; Berlin.
  • Mellor F, Breen A, Fowler J, Senior C, Muggleton J, Hogg J. Sensitivity and Specificity of Objective Spinal Motion Imaging Analysis (OSMIA) in Detecting Lumbar Discs that have Significant MR Degeneration European Conference on Radiology. Vienna, 2007.
  • Breen AC, Muggleton JM, Mellor FE. An Objective Spinal Motion Image Assessment (OSMIA): reliability, accuracy, and exposure data. BMC Musculoskeletal Disorders 2006; 7:1-10
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  • Breen A, Mellor F, Muggleton J, Morris A, Fowler J, Mason W, Bagust J, Senior C. Lumbar Inter-vertebral side-bending motion in asymptomatic subjects. Spine Society of Europe. Annual Meeting. Istanbul, 2006.
  • Breen A, Muggleton J, Mellor F, Morris A, Eisenstein S, Thomas L. Lumbar intervertebral motion in asymptomatic and post fusion subjects. J Bone Joint Surgery Br Proceedings. 2005; 87-B:35.
  • Eisenstein S, Breen A. Lumbar fusion: looking for failure. In: Szpalski M, Gunzburg R, editors. The Failed Spine. Philadelphia: Lippincott Williams & Wilkins; 2005:25-33.
  • Breen A. A new technique for the quantification of intervertebral motion in vivo: A brief overview. Bournemouth, UK: IMRCI, AECC, 2003:1-3.
  • Breen A, Muggleton J, Mellor F, Morris A, Eisenstein S, Thomas L. Tracking fluoroscopic images to assess the integrity of lumbar spine fusion. RAD Magazine. 2003(August):31.
  • Breen AC, Mellor F, Muggleton J. An objective spinal imaging assessment (OSMIA) of the integrity of lumbar spine stabilisation grafts. European Congress of Radiology. 2003, 7-11 March; Vienna, Austria.
  • Breen A, Muggleton J, Kondracki M, Wright J, Morris A. Lumbar spine motion palpation compared with objective intervertebral motion analysis: preliminary findings. European Journal of Chiropractic. 2002; 50:27-32.
  • Muggleton JM, Allen R. Automatic Location of Vertebrae in Digitized Videofluoroscopic Images of the Lumbar Spine. Medical Engineering and Physics. 1997; 19:77-89.
  • Breen AC, Allen R. Digital videofluoroscopy and abnormal spinal movement. In: Aspden RM, Porter RW, editors. Lumbar Spine Disorders: Current Concepts. Singapore: World Scientific, 1996; 79-88.
  • Breen AC, Brydges R, Nunn H, Kause J, Allen R. Quantitative analysis of lumbar spine intersegmental motion. European Journal of Physical Medicine and Rehabilitation. 1993; 3(5):182-90.
  • Bracale M, Denoth F, editors. The use of digitised videofluoroscopic images in the analysis of spinal mechanics in-vivo. VI Mediterranean Conference on Medical and Biological Engineering. 1992; Capri. CNR.
  • Breen AC. Integrated spinal motion: A study of two cases. Journal of the Canadian Chiropractic Association. 1991; 35(1):25-30.
  • Breen AC. The analysis of spine kinematics using digital videofluoroscopy. 7th European Society of Biomechanics; 1990; Aarhus, Denmark.
  • Humphreys K, Breen A, and Saxton D. Incremental lumbar spine motion in the coronal plane: an observer variation study using digital videofluoroscopy. European Journal of Chiropractic. 1990; 38:56-62.
  • Breen AC, Allen R, Morris A. Spine kinematics: a digital videofluoroscopic technique. Journal of Biomedical Engineering. 1989 May; 11(3):224-8.
  • Breen AC. The measurement of the kinematics of the human spine using digital videofluoroscopy. Southampton: University of Southampton, 1989.
  • Breen AC, Allen R, Morris A. A digital videofluoroscopic technique for spine kinematics. Journal of Medical Engineering & Technology. 1989; 13(1-2):109-13.
  • Breen A, Allen R, Morris A. An image processing method for spine kinematics - preliminary studies. Clinical Biomechanics. 1988; 3:5-10.
  • Breen AC. A computer/x-ray method for measuring spinal segmental movement: a feasibility study. 2nd Annual Conference on Research and Education of the Pacific Consortium for Chiropractic Research; 1987 June 13-14; Belmont, California, USA.

The technology has been described extensively in multiple published studies. In the 2009 publication by Mellor, et al., the researchers showed that using the KineGraph VMA technology in asymptomatic subjects can provide normative reference data for evaluating patients. Furthermore, substantially different KineGraph plots—for instance, plots indicating laxity—were obtained for patients with chronic back pain.

In the 2006 publication by Breen, et al., the researchers validated the technology on a normative dataset of asymptomatic patients and demonstrated the system’s measurement accuracy against a reference model. This study also noted that the resulting radiation dose is approximately equivalent to the dose received with two plain x-rays. The researchers concluded that the technology “can also detect paradoxical motion, irregular motion or stiffness. This might inform surgical decisions about spinal stabilization of deformity correction, including the choice of instrumentation in individual cases.”

Using fluoroscopy to capture spine motion

  • Teyhen DS, Flynn TW, Childs JD, et al. Fluoroscopic video to identify aberrant lumbar motion. Spine 2007;32(7):E220-229
  • Wong, KWM, et. al. Continuous Dynamic Spinal Motion Analysis. Spine 2006; 31(4):414-419
  • Wong, KVM, et. al. The Flexion/Extension Profile of 100 Healthy Volunteers. Spine 2004; 29(15):1636-1641
  • Harada, et. al. Cineradiographic Motion Analysis of Normal Lumbar Spine During Forward and Backward Flexion. Spine 2000;25(15):1932-1937
  • Hino H, et. al. Dynamic motion analysis of normal and unstable cervical spines using cineradiography. An in vivo study. Spine 1999;15;24(2):163-8
  • Okawa A, et. al. Dynamic motion study of the whole lumbar spine by videofluoroscopy. Spine 1999;23(16):1743-9
  • Cholewicki J, McGill SM, Wells RP, Vernon H. Method for measuring vertebral kinematics from videofluoroscopy. Clinical Biomechanics 1991;6:73-78

These researchers have proven out the concept using digital video fluoroscopy as a tool for analyzing intervertebral motion.

Spine motion matters

  • Ogon M, Bender BR, Hooper DM, et al. A dynamic approach to spinal instability, part II: hesitation and giving-way during interspinal motion. Spine 1997;22:2859-2866
  • Pope MH, Frymoyer JW, Krag MH. Diagnosing instability. Clin Orthop. 1992;279:60-67
  • Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord 1992;5:383-9
  • Panjabi MM. The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. J Spinal Disord 1992;5:390-6

These studies highlight the importance of capturing mid-range data, where instabilities are likely to occur.

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CAUTION: Investigational device, limited by federal (United States) law to investigational use.

Pilot studies suggest this device has the potential to detect an array of spine motion dysfunctions, assess kinematics, and track adjacent level disease; Ortho Kinematics, Inc. is currently conducting a multi-center clinical trial to evaluate and further assess these potential capabilities.