Spinal Instability occurs when a spine vertebra slips, and can be painful. Spinal instability is a leading indication for spine fusion surgery.



Vertebral Motion Analysis

A more sensitive, highly-specific test for spinal instability based on spine motion analysis.

Since the early 1940s, spinal instability testing has been very low-tech.

Today's current spinal instability test—standard bending x-rays of the spine—requires measuring spine motion from static x-rays by hand. This test is ordered 5 million times per year in the US, more than spine CT and MR imaging combined.

VMA delivers improved spine motion analysis, updated for the 21st century.


  • Uses standard C-arms (fluoroscopes) to generate images
  • See FDA-cleared lumbar and cervical indications for use
  • Covered under category I CPT codes*

* Ortho Kinematics, Inc. does not provide coding advice, however customers have reported receiving reimbursement for VMA testing under current Category I CPT codes.


VMA devices assist patients through a complete spine bend

Unlike traditional bending x-rays of the spine in which patients are free to bend as much or as little as they want, VMA testing assist patients through a complete spine bend, helping to gently overcome the "guarding" that often occurs during painful spine bending, helping to assure instability does not go undetected.

VMA testing was validated in the largest level 1 Evidence study of its kind to be 500% more sensitive in detecting lumbar radiographic instability, but just as specific1.

1 Based on a threshold for dynamic lumbar slip of 5.3 mm or 15% of vertebral body depth. In a "head-to-head" study of 870 consecutive spine surgical clinic patients and 240 pain-free controls, VMA detected lumbar radiographic instability in 11.5% of patients and only 0.5% of pain-free controls. For comparison, traditional flexion/extension bending x-rays detected lumbar radiographic instability in only 5.5% of the patient population and 0.5% of the pain free controls. Data on file with Ortho Kinematics, Inc.

Cloud-based imaging informatics

VMA test results are uploaded to cloud servers where they are processed to produce motion measurements that can assess instability. Instability testing results and video x-ray (fluoro) images of spine motion are available within hours via any internet connected computer, tablet, or smartphone.

Online surgeon tools can be helpful in interactions with insurance companies to get spine surgery approved, and the videos overlaid with quantitative diagnostic data can make patient consults more effective.

Easily integrated into your clinical workflow


  • Imaging is done with standard surgical C-arms (fluoroscopes), typically requiring no new staff or imaging machines and a day or two of training.
  • VMA testing takes about 5 minutes more than a 15 minute flex-ex.
  • The VMA system is HIPAA-compliant, is browser-based, has a "zero IT footprint" requiring no installed software, and easily integrates with PACS systems.
  • VMA offers more robust data with less radiation than a flex-ex2. This means lower exposures may be possible for both the patient and technologist.

2As a fluoroscopy based test, the VMA presents opportunities to reduce radiation exposure to the patient as compared to plain x-rays, which involve a much higher per-image dose of radiation. See Mellor, FE et. al. "Moving back: The radiation dose received from lumbar spine quantitative fluoroscopy compared to lumbar spine radiographs with suggestions for dose reduction." Radiography. Vol. 20, Issue 3, pp. 251–257, Aug. 2014.

Advanced functional imaging isn’t just for cardiologists anymore.

  • Detects instability at higher rates
  • Helps address insurance denials
  • Easy to integrate into clinical workflow
  • Supported by compelling science
  • Lower radiation exposure to patient

VMA: Advanced functional imaging for the spine