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Lumbar Segmental Instability Classification: Functional, Structural and Multiple Instability

Low back pain (LBP) is a widespread condition. One of the common cause of LBP is lumbar segmental instability (LSI). The understanding of LSI can be improved by dividing cases into three subcategories: functional instability; if neuromuscular system is dysfunctional, structural instability; if osseoligamentous structure is disrupted, and multiple instability; if both subcategories are existed. Elucidating distinctions between sub-classifications might improve common understanding regarding LSI subcategories among physical therapists, radiologists and spinal physicians. The purpose of this review is to highlight the distinctions among the three LSI subcategories, which includes their definitions, scientific evidence, and clinical tests. This review will help to improve understanding of LSI and guide clinical diagnostic decisions. Additionally, this review might help in future research on LSI into three distinct and clinically meaningful sub-classifications.