=====White-Panjabi classification===== Spinal instability Classification Anterior and posterior elements Anterior elements destroyed or unable to function: 2 points Posterior elements destroyed or unable to function: 2 points Flexion-extension radiographs Sagittal plane translation < 4.5mm or 15%: 2 points Sagittal plane rotation: 2 points (rotation = 15° at L1-L4, 20° at L4L5 or 25° at L5S1) Resting radiographs Sagittal plane displacement < 4.5mm or 15%: 2 points Relative sagittal plane angulation < 22° Other Cauda equina damage: 3 points Dangerous loading anticipated: 1 point Interpretation 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.)).