Anterior and posterior elements
|Anterior elements destroyed or unable to function:||2 points|
|Posterior elements destroyed or unable to function:||2 points|
|Sagittal plane translation < 4.5mm or 15%:||2 points|
|Sagittal plane rotation:||2 points|
Note: sagittal plane rotation is 15° at L1-L4, 20° at L4L5 or 25° at L5S1
|Sagittal plane displacement < 4.5mm or 15%:||2 points|
|Relative sagittal plane angulation < 22°:|
|Cauda equina damage:||3 points|
|Dangerous loading anticipated:||1 point|
If the sum of the points is five or more, then the spine is considered clinically unstable.
Panjabi MM. Clinical spinal instability and low back pain. Journal of Electromyography and Kinesiology 2003; 13:371-379.