Anterior and posterior elements
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.
Manohar M. Panjabi obtained his undergrad- uate degree in mechanical engineering from Birla College of Engineering, Pilani, India, and his PhD degree in machine design from Chal- mers University of Technology, Gothenburg, Sweden. He has held various faculty positions at Yale University. He is currently a professor in the Departments of Orthopaedics and Rehabilitation, and Mechanical Engineering, director of Biomechanics Research Laboratory. His research interest focuses on human spine, especially the basic understanding of its function, injuries and clinical problems, which may be addressed advan- tageously with the biomechanical tools.