Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation.

Boden, Scott D.; Davis, D O; Dina, T S; Patronas, N J; Wiesel, Saul

doi:10.2106/00004623-199072030-00013

Cited by 2,033 publications

(1,020 citation statements)

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“…The explanation for this is that in the adjacent segment cephalad to a fusion there is increased mobility compared with the adjacent caudal segment [5]. A recent clinical study showed that ASD occurred in 89% of the cases cephalad to lumbar fusion, 3.7% of the cases caudal and combined cephalad and caudal in 7.5% of the cases [10].…”

Section: Discussionmentioning

confidence: 99%

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Does Wallis implant reduce adjacent segment degeneration above lumbosacral instrumented fusion?

et al. 2009

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Delayed complications following lumbar spine fusion may occur amongst which is adjacent segment degeneration (ASD). Although interspinous implants have been successfully used in spinal stenosis to authors' knowledge such implants have not been previously used to reduce ASD in instrumented lumbar fusion. This prospective controlled study was designed to investigate if the implantation of an interspinous implant cephalad to short lumbar and lumbosacral instrumented fusion could eliminate the incidence of ASD and subsequently the related reoperation rate. Groups W and C enrolled initially each 25 consecutive selected patients. Group W included patients, who received the Wallis interspinous implant in the unfused vertebral segment cephalad to instrumentation and the group C selected age-, diagnosis-, level-, and instrumentationmatched to W group patients without interspinous implant (controls). The inclusion criterion for Wallis implantation was UCLA arthritic grade \II, while the exclusion criteria were previous lumbar surgery, severe osteoporosis or degeneration[UCLA grade II in the adjacent two segments cephalad to instrumentation. All patients suffered from symptomatic spinal stenosis and underwent decompression and 2-4 levels stabilization with rigid pedicle screw fixation and posterolateral fusion by a single surgeon. Lumbar lordosis, disc height (DH), segmental range of motion (ROM), and percent olisthesis in the adjacent two cephalad to instrumentation segments were measured preoperatively, and postoperatively until the final evaluation. VAS, SF-36, and Oswestry Disability Index (ODI) were used. One patient of group W developed pseudarthrosis: two patients of group C deep infection and one patient of group C ASD in the segment below instrumentation and were excluded from the final evaluation. Thus, 24 patients of group W and 21 in group C aged 65? 13 and 64? 11 years, respectively were included in the final analysis. The follow-up averaged 60 ± 6 months. The instrumented levels averaged 2.5 ? 1 vertebra for both groups. All 45 spines showed radiological fusion 8-12 months postoperatively. Lumbar lordosis did not change postoperatively. Postoperatively at the first cephalad adjacent segment: DH increased in the group W (P = 0.042); ROM significantly increased only in group C (ANOVA, P \ 0.02); olisthesis decreased both in flexion (P = 0.0024) and extension (P = 0.012) in group W. The degeneration or deterioration of already existed ASD in the two cephalad segments was shown in 1 (4.1%) and 6 (28.6%) spines in W and C groups, respectively. Physical function (SF-36) and ODI improved postoperatively (P \ 0.001), but in favour of the patients of group W (P \ 0.05) at the final evaluation. Symptomatic ASD required surgical intervention was in 3 (14%) patients of group C and none in group W. ASD remains a significant problem and accounts for a big portion of revision surgery following instrumented lumbar fusion. In this series, the Wallis interspinous implant changed the natural history of ASD and saved th...

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Section: Discussionmentioning

confidence: 99%

“…Recently, several implants have been developed with non-bony fixation, some connecting spinous processes, and laminae [5,42] other connecting two adjacent spinous processes [38].…”

Section: Discussionmentioning

confidence: 99%

Does Wallis implant reduce adjacent segment degeneration above lumbosacral instrumented fusion?

et al. 2009

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“…Boden et al [2] have shown that disc degeneration at an average of three levels can be seen in up to 90% of asymptomatic people over the age of 60 years. Sato and Kikuchi's [21] report shows that even the finding of radiographic instability should be correlated clinically, as the significance of 'instability' varies from patient to patient.…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of functional outcomes and radiographic changes at adjacent levels following lumbar spine fusion for degenerative disc disease

2000

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“…11 Causes of symptoms of LBP remain un- known despite full and appropriate use of modern imagining techniques. 12,13 Finding of sacroiliac joint dysfunction is indicative of damage to ligaments or the low back. [14][15][16] Research has indicated that most patients with lumbar pain do not have neurological problems but back pain usually results from injury related to the soft tissues.…”

Section: Discussionmentioning

confidence: 99%

Treatment of chronic low back pain incorporating active patient participation and chiropractic: a retrospective case report

Legier

2005

Journal of Chiropractic Medicine

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Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation.

Cited by 2,033 publications

References 0 publications

Does Wallis implant reduce adjacent segment degeneration above lumbosacral instrumented fusion?

Does Wallis implant reduce adjacent segment degeneration above lumbosacral instrumented fusion?

Long-term follow-up of functional outcomes and radiographic changes at adjacent levels following lumbar spine fusion for degenerative disc disease

Treatment of chronic low back pain incorporating active patient participation and chiropractic: a retrospective case report

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