Objective: This research studied the in vivo motion characteristics of the L3-S1 lumbar spine with facet-joint degeneration during functional activities. Methods: Thirteen male and 21 female patients with facet-joint degeneration at the L3-S1 spinal region were included in the study. The L3-S1 lumbar segments of all the patients were divided into 3 groups according to the degree of facet-joints degeneration (mild, moderate, or severe). The ranges of motion (ROM) of the vertebrae were analyzed using a combination of computed tomography and dual fluoroscopic imaging techniques. During functional postures, the ROMs were compared between the 3 groups at each spinal level (L3-L4, L4-L5, and L5-S1). Results: At L3-L4 level, the primary rotations between the mild and moderate groups during left-right twisting activity were significantly different. At L4-L5 level, the primary rotation of the moderate group was significantly higher than the other groups during flexion-extension. During left-right bending activities, a significant difference was observed only between the moderate and severe groups. At L5-S1 level, the rotation of the moderate group was significantly higher than the mild group during left-right bending activity. Conclusions: Degeneration of the facet joint alters the ROMs of the lumbar spine. As the degree of facet-joint degeneration increased, the ROMs of the lumbar vertebra that had initially increased declined. However, when there was severe facet-joint degeneration, the ROMs of the lumbar spine declined to levels comparative to the moderate group. The relationship between the stability of the lumbar vertebra and the degree of facet-joint degeneration requires further study.

Objective This research studied the in vivo motion characteristics of the L3-S1 lumbar spine with facet-joint degeneration during functional activities. Methods Thirteen male and 21 female patients with facet-joint degeneration at the L3-S1 spinal region were included in the study. The L3-S1 lumbar segments of all the patients were divide into 3 groups according to the degree of facet joints degeneration (mild, moderate or severe). The ranges of motion (ROM) of the vertebrae was analyzed using a combination of computed tomography and dual fluoroscopic imaging techniques. During functional postures, the ROMs were compared between the 3 groups at each spinal level (L3-L4, L4-L5, and L5-S1). Results At L3-L4 level, the primary rotations between the mild and moderate groups during left-right twisting activity were significantly different. At L4-L5 level, the primary rotation of the moderate group was significantly higher than the other groups during flexion-extension. During left-right bending activities a significant difference was observed only between the moderate and severe groups. At L5-S1 level, the rotation of the moderate group was significantly higher than the mild group during left-right bending activity. Conclusions Degeneration of the facet joint alters the ROMs of the lumbar spine. As the degree of facet-joint degeneration increased, the ROMs of the lumbar vertebra that had initially increased, declined. However, when there was severe facet-joint degeneration, the ROMs of lumbar spine declined to levels comparative to the moderate group. The relationship between the stability of the lumbar vertebra and the degree of facet-joint degeneration requires further study.

Objective: The aim of this study was to measure the 3D motion of cervical vertebra with different curvatures under seven functional postures and investigate the relationship between cervical spine curvatures and the kinematics of each functional motion unit. Methods: Seventy-five volunteers were classified into 5 curvature groups based on the C1-C7 Cobb angle of sagittal alignment. These were: a normal group, straight group, kyphosis group and hyper and hypolordosis groups. All volunteers underwent cervical spine CBCT scans at 7 functional positions. The range-of-motion (ROM) of each vertebra and the overall cervical spine were measured using a 3D-3D registration technique. Results: In comparison to the normal group, the ROM of C3-C4 during left-right twisting in the kyphotic group was significantly higher, while the ROM of C1-C2 during left-right bending was also significantly greater. In addition, the ROM of C5-C6 in the straight group was higher during left-right bending in comparison to the normal group. During flexion-extension, the ROM of C4-C5 in kyphotic subjects was significantly lower than in the normal group, while in the C5-C6 segment, the ROM of the straight and the kyphotic groups was significantly greater compared to the normal group. During left-right bending, the global ROM of kyphotic subjects was higher than in the normal group. Conclusions: 3D kinematics was used to accurately quantify the ROM of cervical spine under different curvatures under physiological load. The data implied that cervical kyphosis may have a greater impact on ROM. Our findings may contribute to prevent cervical spondylosis by early intervention in curvature changes.

BackgroundFew reports have been conducted to comparing surgical results and safety evaluations between the different types of infections in geriatric patients with thoracolumbar infections. The aim of this study is to investigate the safety and efficacy of surgical treatment for thoracolumbar infections in elderly patients.Methods21 patients with pyogenic spondylodiscitis (PS) and 26 patients with tuberculous spondylodiscitis (TS) were enrolled in the study. All patients were treated using one-stage posterior debridement, decompression, and pedicle screw fixation. Comparison of operative safety parameters between the two groups. Clinical efficacy was evaluated using visual analogue scale (VAS) score, the American Spinal Injury Association (ASIA) grade, the short form (SF)-36 survey and Oswestry disability index (ODI) to determine patient quality of life pre- and post-operatively. Results Hospitalisation and intensive care unit duration in the PS group were significantly shorter than in the TS group (P<0.05). The total incidence of post-operative complications for both groups was 44.7%. More complications occurred in the TS group, but the difference was not significant. The VAS and SF-36 scores (physical component) were significantly better in the PS group six months post-operatively, and the SF-36 (mental component) scores were significantly better in the PS group at the one-year follow-up. Neurological status in both groups improved post-operatively, and 83% of the patients were satisfied with the results of their operation. Imaging results showed that bone graft fusion improved in both groups at six months, one year and at the final follow-up. ConclusionOne-stage posterior debridement, decompression, interbody fusion, and internal fixation can be considered a safe and effective method of treating spinal infections in the elderly. This method can improve nerve function, reconstruct spinal stability, and enhance the quality of life of elderly patients. Both PS and TS who underwent surgery achieve similar clinical and radiological results.

Objective: This research studied the in vivo motion characteristics of the L3-S1 lumbar spine with facet-joint degeneration during functional activities.Methods: Thirteen male and 21 female patients with facet-joint degeneration at the L3-S1 spinal region were included in the study. The L3-S1 lumbar segments of all the patients were divide into 3 groups according to the degree of facet joints degeneration (mild, moderate or severe). The ranges of motion (ROM) of the vertebrae was analyzed using a combination of computed tomography and dual fluoroscopic imaging techniques. During functional postures, the ROMs were compared between the 3 groups at each spinal level (L3-L4, L4-L5, and L5-S1). Results: At L3-L4 level, the primary rotations between the mild and moderate groups during left-right twisting activity were significantly different. At L4-L5 level, the primary rotation of the moderate group was significantly higher than the other groups during flexion-extension. During left-right bending activities a significant difference was observed only between the moderate and severe groups. At L5-S1 level, the rotation of the moderate group was significantly higher than the mild group during left-right bending activity.Conclusions: Degeneration of the facet joint alters the ROMs of the lumbar spine. As the degree of facet-joint degeneration increased, the ROMs of the lumbar vertebra that had initially increased, declined. However, when there was severe facet-joint degeneration, the ROMs of lumbar spine declined to levels comparative to the moderate group. The relationship between the stability of the lumbar vertebra and the degree of facet-joint degeneration requires further study.