Disc Degeneration Affects the Multidirectional Flexibility of the Lumbar Spine

Mimura, Masaya; Panjabi, M M; Oxland, Tom; Crisco, Joseph J.; Yamamoto, Isao; Vasavada, Anita N.

doi:10.1097/00007632-199406000-00011

Cited by 393 publications

(313 citation statements)

References 0 publications

Supporting

Mentioning

258

Contrasting

Unclassified

Order By: Relevance

“…The hypothesis of increased flexibility for early, mildly degenerated discs was tested in numerous in vitro studies. Some papers have reported an increment in spinal flexibility for mild degeneration [20,41,63] while other investigations have found either an increase in spinal stiffness with progressing degeneration [37,45,78] or a combination of both [50]. Tanaka et al [63] found maximal flexibility in axial rotation in the lower lumbar spine for the grade III of the Thompson scale [64], whereas minimal changes in the spine motion were found in flexion, extension and lateral bending.…”

Section: Flexibilitymentioning

confidence: 99%

Ageing and degenerative changes of the intervertebral disc and their impact on spinal flexibility

et al. 2014

View full text Add to dashboard Cite

Purpose Degeneration of the intervertebral disc is associated with various morphological changes of the disc itself and of the adjacent structures, such as reduction of the water content, collapse of the intervertebral space, disruption and tears, and osteophytes. These morphological changes of the disc are linked to alterations of the spine flexibility. This paper aims to review the literature about the ageing and degenerative changes of the intervertebral disc and their link with alterations in spinal biomechanics, with emphasis on flexibility. Methods Narrative literature review. Results Clinical instability of the motion segment, usually related to increased flexibility and hypothesized to be connected to early, mild disc degeneration and believed to be responsible for low back pain, was tested in numerous in vitro studies. Despite some disagreement in the findings, a trend toward spinal stiffening with the increasing degeneration was observed in most studies. Tests about tears and fissures showed inconsistent results, as well as for disc collapse and dehydration. Vertebral osteophytes were found to be effective in stabilizing the spine in bending motions. Conclusions The literature suggests that the degenerative changes of the intervertebral disc and surrounding structures lead to subtle alteration of the mechanical properties of the functional spinal unit. A trend toward spinal stiffening with the increasing degeneration has been observed in most studies.

show abstract

Section: Flexibilitymentioning

confidence: 99%

Ageing and degenerative changes of the intervertebral disc and their impact on spinal flexibility

et al. 2014

View full text Add to dashboard Cite

show abstract

“…This process is widely described as degenerative disc disease (DDD), which is a natural and highly prevalent condition [1]. It is widely accepted that DDD alters mechanical properties of IVDs, and therefore biomechanics of the motion segment [2][3][4]. Degenerated discs that cause back pain and do not respond to conservative treatment are traditionally treated by spinal fusion.…”

Section: Introductionmentioning

confidence: 99%

An in vitro biomechanical comparison of Cadisc™-L with natural lumbar discs in axial compression and sagittal flexion

McNally

Naylor

Johnson³

2012

Eur Spine J

View full text Add to dashboard Cite

Introduction The elastomeric, monobloc disc prosthesis (Cadisc TM -L, Ranier Technology, Cambridge, UK) aims to preserve biomechanics of an implanted spinal motion segment. Study design This study presents the findings of an in vitro investigation on the effect of implantation of Cadisc TM -L. Compressive stiffness, flexion stiffness at 10, 20, 30 and 40 Nm and the instant-axis-of-rotation (IAR) loci are compared before and after implantation of a MC-10 mm-6°Cadisc TM -L. MethodsFresh frozen human monosegmental lumbar spines (n = 8) were prepared, potted and tested in an environmentally controlled chamber to simulate in vivo conditions. Specimens were preconditioned by loading to 500 N for 30 min. Compressive stiffness of the specimen was determined by applying pure compression of 1 kN at 250 N/s via a loading roller positioned at the central loading axis (CLA). The roller was then offset 12.5 mm anterior of the CLA and the loading regime repeated to test specimens in flexion. Bending moments were calculated from the applied load and corresponding flexion angle. The IAR locus was tracked by a motion-tracking camera. Results ConclusionsImplantation of Cadisc TM -L caused a reduction in axial stiffness, but maintained disc height and flexion stiffness. IAR loci remained mobile without large displacement of the centroid from the intact spine position.

show abstract

“…8.8°± 1.8°** 3.4°± 0.9°\0.01 *, **P \ 0.05 degeneration was also occurring in the control group due to age, which then increased the rotational angle compared with data in previous reports. The role of degenerated intervertebral discs in degenerative spinal instability has previously been clarified by means of biomechanical cadaver studies [5,11,14,16,17]. In one study on flexion-extension and axial rotation, the flexibility parameters increased with disc degeneration [11].…”

Section: Discussionmentioning

confidence: 99%

“…The role of degenerated intervertebral discs in degenerative spinal instability has previously been clarified by means of biomechanical cadaver studies [5,11,14,16,17]. In one study on flexion-extension and axial rotation, the flexibility parameters increased with disc degeneration [11]. Another cadaver study revealed that axial rotational motion was most affected by disc degeneration rather than facet joints, and segmental motion increased with increasing severity of disc degeneration [5].…”

Section: Discussionmentioning

confidence: 99%

Rotational hypermobility of disc wedging using kinematic CT: preliminary study to investigate the instability of discs in degenerated scoliosis in the lumbar spine

et al. 2010

View full text Add to dashboard Cite

The number of patients showing lumbar degenerative scoliosis, including disc wedging, has increased, and examination of the mechanism of spinal nerve compression due to lateral and rotational mobility of the lumbar spine is necessary. Thirty-two patients with L4-L5 disc wedging but without antero-or retrospondylolisthesis and ten age-matched controls were examined. The angle of disc wedging and change in the angle between left and right bending were evaluated by anterior-posterior X-ray images of patients while they were in a standing position. The degree of disc degeneration and existence of vacuum phenomena were evaluated at the L4-L5 discs. Rotational mobility between maximal right and left rotation was examined by computed tomography (CT). Rotational mobility was measured using the spinal transverse processes of L4 and L5. The relationship between these factors was statistically evaluated using multivariate analysis and Spearman's correlation test. There was a significant increase in the average rotational mobility of the L4-L5 disc-wedging group. In the L4-L5 disc-wedging group, the increased angle of disc wedging and change in the angle between left and right bending correlated with increased rotational mobility. The degree of disc degeneration did not affect rotational mobility. However, existence of vacuum phenomena increased the rotational mobility of the L4-L5 disc-wedging group. This is the first study to evaluate the rotational hypermobility of L4-L5 disc wedging in patients without antero-or retrospondylolisthesis using kinematic CT. Increases in the wedging angle and abnormal instability of lateral bending correlated with increased rotational mobility. For surgical planning of degenerative L4-L5 disc wedging, it is important to consider rotational hypermobility using kinematic CT or X-ray imaging findings of lateral bending.

show abstract

Disc Degeneration Affects the Multidirectional Flexibility of the Lumbar Spine

Cited by 393 publications

References 0 publications

Ageing and degenerative changes of the intervertebral disc and their impact on spinal flexibility

Ageing and degenerative changes of the intervertebral disc and their impact on spinal flexibility

An in vitro biomechanical comparison of Cadisc™-L with natural lumbar discs in axial compression and sagittal flexion

Rotational hypermobility of disc wedging using kinematic CT: preliminary study to investigate the instability of discs in degenerated scoliosis in the lumbar spine

Contact Info

Product

Resources

About