Which lateral radiographic positioning technique provides the most reliable and functional representation of a patients sagittal balance?
STUDY DESIGN: Prospective nonscoliotic cohort evaluation of the effects of various positions for obtaining standing lateral thoracolumbar radiographs. OBJECTIVE: The purpose of this study was to compare the effects of various upper extremity positions on thoracolumbar sagittal spinal alignment. SUMMARY OF BACKGROUND DATA: The standing position used to capture a lateral plane radiograph can have marked effects on measurements of sagittal spinal alignment and may compound the variability between measurements from successive radiographs. METHODS: Twenty-two healthy female adolescents performed 3 repeated trials of 4 standing positions in a motion analysis laboratory. The positions included: (1) relaxed standing with arms at sides (CONTROL), (2) standing with fists overlying ipsilateral clavicles (CLAVICLE), (3) active shoulder flexion to 30 degrees with elbows extended (30 ACTIVE), and (4) passive shoulder flexion to 30 degrees with hand supports (30 PASSIVE). Sagittal alignment of the sp