Does Radiographic Osteoarthritis Correlate with Flexibility of the Lumbar Spine?

Weiner, Debra K.; Distell, B M; Studenski, Stephanie; Martinez, Salutario; Lomasney, Laurie M; Bongiorni, Dennis

doi:10.1111/j.1532-5415.1994.tb01748.x

Cited by 80 publications

(53 citation statements)

References 22 publications

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“…The radiographic grade for the L5-S1 disc was measured in plain radiographs with the modified method by Weiner et al [12]. The scoring system has four grades.…”

Section: Methodsmentioning

confidence: 99%

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Arthrodesis to L5 versus S1 in long instrumentation and fusion for degenerative lumbar scoliosis

et al. 2009

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There is a debate regarding the distal fusion level for degenerative lumbar scoliosis. Whether a healthy L5-S1 motion segment should be included or not in the fusion remains controversial. The purpose of this study was to determine the optimal indication for the fusion to the sacrum, and to compare the results of distal fusion to L5 versus the sacrum in the long instrumented fusion for degenerative lumbar scoliosis. A total of 45 patients who had undergone long instrumentation and fusion for degenerative lumbar scoliosis were evaluated with a minimum 2 year follow-up. Twenty-four patients (mean age 63.6) underwent fusion to L5 and 21 patients (mean age 65.6) underwent fusion to the sacrum. Supplemental interbody fusion was performed in 12 patients in the L5 group and eleven patients in the sacrum group. The number of levels fused was 6.08 segments (range 4-8) in the L5 group and 6.09 (range 4-9) in the sacrum group. Intraoperative blood loss (2,754 ml versus 2,938 ml) and operative time (220 min versus 229 min) were similar in both groups. The Cobb angle changed from 24.7°before surgery to 6.8°after surgery in the L5 group, and from 22.8°to 7.7°in the sacrum group without statistical difference. Correction of lumbar lordosis was statistically better in the sacrum group (P = 0.03). Less correction of lumbar lordosis in the L5 group seemed to be associated with subsequent advanced L5-S1 disc degeneration. The change of coronal and sagittal imbalance was not different in both groups. Subsequent advanced L5-S1 disc degeneration occurred in 58% of the patients in the L5 group. Symptomatic adjacent segment disease at L5-S1 developed in five patients. Interestingly, the development of adjacent segment disease was not related to the preoperative grade of disc degeneration, which proved minimal degeneration in the five patients. In the L5 group, there were nine patients of complications at L5-S1 segment, including adjacent segment disease at L5-S1 and loosening of L5 screws. Seven of the nine patients showed preoperative sagittal imbalance and/or lumbar hypolordosis, which might be risk factors of complications at L5-S1. For the patients with sagittal imbalance and lumbar hypolordosis, L5-S1 should be included in the fusion even if L5-S1 disc was minimal degeneration.

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“…The radiographic grade for the L5-S1 disc was measured in plain radiographs with the modified method by Weiner et al [12]. The scoring system has four grades.…”

Section: Methodsmentioning

confidence: 99%

“…The L5-S1 disc degeneration was assessed by the Weiner method [12]. Grade 0 or 1 disc degeneration was considered healthy, whereas grade 2 or 3 was considered as advanced degeneration.…”

Section: Radiological Evaluationmentioning

confidence: 99%

Arthrodesis to L5 versus S1 in long instrumentation and fusion for degenerative lumbar scoliosis

et al. 2009

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“…In fact, severity of imaging-documented spinal pathology has been previously touted as having poor predictive validity for both pain and disability (Jarvik et al, 2001). We used a detailed radiographic scoring instrument with previously established reliability and validity in our study (Weiner et al, 1994), which may have enabled us to determine more subtle differences than could have been previously accomplished.…”

Section: Discussionmentioning

confidence: 99%

“…Radiographic Pathology. Severity of degenerative lumbosacral pathology was scored using an established system (Weiner et al, 1994), with disc and facet involvement scored for each level (T12 through S1; 0 = no disease, 3 = severe disease). Disc and facet summary scores were then calculated.…”

Section: Biomedical Constructs Andmentioning

confidence: 99%

The impact of chronic low back pain on older adults: A comparative study of patients and controls

Rudy

Weiner

Lieber

et al. 2007

Pain

Self Cite

214

179

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Chronic low back pain (CLBP) is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. Many older adults remain quite functional despite CLBP, and because age-related comorbidities often exist independently of pain (e.g., medical illnesses, sleep disturbance, mobility difficulty), the unique impact of CLBP is unknown. We conducted this research to identify the multidimensional factors that distinguish independent community dwelling older adults with CLBP from those that are pain-free. Three hundred twenty cognitively intact participants (162 with ≥ moderate pain for ≥ 3 months, and 158 pain-free) underwent comprehensive assessment of pain severity, medical comorbidity (illnesses, body mass index, medications), severity of degenerative disc and facet disease, lumbar flexion, psychological constructs (self-efficacy, mood, overall mental health), and self-reported as well as performance-based physical function. Significant differences were ascertained for all 22 measures. Discriminant function analysis revealed that eight measures uniquely maximized the separation between the two groups (self-reported function with the Functional Status Index and the SF-36, performance-based function with repetitive trunk rotation and functional reach, mood with the Geriatric Depression Scale, comorbidity with the Cumulative Illness Rating Scale and BMI, and severity of degenerative disc disease). These results should help to guide investigators that perform studies of CLBP in older adults and practitioners that want an easily adaptable battery for use in clinical settings.

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“…The radiographs were graded using the system developed by Weiner and colleagues (29), and the MRI scans were graded using the technique described by Videman and colleagues (30). There is no rating scale for radiographic or MRI studies that is perfect in estimating the degree of patho-anatomic abnormality in CLBP.…”

Section: Methodsmentioning

confidence: 99%

Evidence of augmented central pain processing in idiopathic chronic low back pain

Giesecke¹,

Gracely²,

Grant³

et al. 2004

Arthritis & Rheumatism

721

456

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Objective. For many individuals with chronic low back pain (CLBP), there is no identifiable cause. In other idiopathic chronic pain conditions, sensory testing and functional magnetic resonance imaging (fMRI) have identified the occurrence of generalized increased pain sensitivity, hyperalgesia, and altered brain processing, suggesting central augmentation of pain processing in such conditions. We compared the results of both of these methods as applied to patients with idiopathic CLBP (n ‫؍‬ 11), patients with widespread pain (fibromyalgia; n ‫؍‬ 16), and healthy control subjects (n ‫؍‬ 11).Methods. Patients with CLBP had low back pain persisting for at least 12 months that was unexplained by MRI/radiographic changes. Experimental pain testing was performed at a neutral site (thumbnail) to assess the pressure-pain threshold in all subjects. For fMRI studies, stimuli of equal pressure (2 kg) and of equal subjective pain intensity (slightly intense pain) were applied to this same site.Results. Despite low numbers of tender points in the CLBP group, experimental pain testing revealed hyperalgesia in this group as well as in the fibromyalgia group; the pressure required to produce slightly intense pain was significantly higher in the controls (5.6 kg) than in the patients with CLBP (3.9 kg) (P ‫؍‬ 0.03) or the patients with fibromyalgia (3.5 kg) (P ‫؍‬ 0.006).When equal amounts of pressure were applied to the 3 groups, fMRI detected 5 common regions of neuronal activation in pain-related cortical areas in the CLBP and fibromyalgia groups (in the contralateral primary and secondary [S2] somatosensory cortices, inferior parietal lobule, cerebellum, and ipsilateral S2). This same stimulus resulted in only a single activation in controls (in the contralateral S2 somatosensory cortex). When subjects in the 3 groups received stimuli that evoked subjectively equal pain, fMRI revealed common neuronal activations in all 3 groups.Conclusion. At equal levels of pressure, patients with CLBP or fibromyalgia experienced significantly more pain and showed more extensive, common patterns of neuronal activation in pain-related cortical areas. When stimuli that elicited equally painful responses were applied (requiring significantly lower pressure in both patient groups as compared with the control group), neuronal activations were similar among the 3 groups. These findings are consistent with the occurrence of augmented central pain processing in patients with idiopathic CLBP.Chronic low back pain (CLBP) is one of the most common and expensive musculoskeletal disorders in developed countries (1,2). Back pain in general affects 70-85% of all people at some time in their lives, but 90% of affected individuals recover, typically within 12 weeks (3). Recovery after 12 weeks is slow and uncertain, and this subset of patients with CLBP accounts for major expenses in the health care and disability systems (2,4).Despite the magnitude of the problem, little is known about the precise cause of CLBP. There is often a mismatch between objectiv...

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Does Radiographic Osteoarthritis Correlate with Flexibility of the Lumbar Spine?

Abstract: We have developed a reliable radiographic scoring instrument for assessing radiographic OA of the LS spine. It appears that painless LS disc OA is one factor that influences spinal motion.

Cited by 80 publications

References 22 publications

Arthrodesis to L5 versus S1 in long instrumentation and fusion for degenerative lumbar scoliosis

Arthrodesis to L5 versus S1 in long instrumentation and fusion for degenerative lumbar scoliosis

The impact of chronic low back pain on older adults: A comparative study of patients and controls

Evidence of augmented central pain processing in idiopathic chronic low back pain

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