Dynamic Bulging of Intervertebral Discs in the Degenerative Lumbar Spine

Zou, Jun; Yang, Huilin; Miyazaki, Masashi; Morishita, Yuichiro; Wei, Feng; McGovern, Scott C.; Wang, Jeffrey C.

doi:10.1097/brs.0b013e3181b32998

Cited by 68 publications

(51 citation statements)

References 25 publications

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“…Pfirrmann apresentou sua classificação para degeneração discal em 2001 16 , demonstrando boa reprodutibilidade inter e intraobservadores, posteriormente confirmada por Puertas et al 23 e Zou et al 20 . Outros autores propuseram modificadores nesta classificação 17,24 ressaltando que, em pacientes mais velhos, até 87% dos discos lombares são incluídos entre os tipos III e IV.…”

Section: Discussionunclassified

“…No exame de ressonância magnética são descritos: diminuição de altura, abaulamentos, herniações, presença de alterações da placa terminal tipo Modic e do disco intervertebral, como apresentado pela classificação de Pfirrmann 3,[15][16][17] . Embora grandes perdas de altura discal impliquem extensa desestruturação do mesmo, não há uma correlação direta bem estabelecida entre o início da degeneração vista em ressonância (classificação de Pfirrmann 16 ) com alteração de sinal do corpo vertebral (classificação de Modic 3,15,[18][19][20][21] . Dessa forma, o presente estudo tem como objetivo comparar as alterações degenerativas encontradas na ressonância magnética, segundo a classificação de Modic e Pfirrmann.…”

Section: Introductionunclassified

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Correlação entre as classificações de Pfirrmann e Modic na degeneração do disco intervertebral lombar

et al. 2010

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OBJETIVO: correlacionar as alterações encontradas nas ressonâncias magnéticas lombares quanto às classificações de Pfirrmann e Modic. MÉTODOS: foram selecionadas 54 ressonâncias lombossacras de pacientes ambulatoriais (23 homens e 31 mulheres) que já se encontravam em investigação por sua comorbidade. Foram classificados 264 discos intervertebrais (L1 a S1) quanto ao grau de degeneração segundo Pfirrmann. A presença de alterações de sinal de corpo vertebral foi registrada quanto à classificação de Modic. Foi aplicado teste χ2, adotando níveis de significância inferiores a 0,05 (a=5%). RESULTADOS: a média de idade pesquisada foi de 48,4 anos (26 a 77 anos). Observou-se maior prevalência de Pfirrmann tipo IV (31,1%). Em 88,3% da amostra o sinal de Modic estava ausente, assim como Modic 3; 60% das alterações Modic 2 foram relacionadas ao Pfirrmann tipo V, e 36,4% das alterações Modic 1 foram igualmente distribuídas entre Pfirrmann tipo IV e V. Encontrou-se associação estatisticamente significante entre as alterações de Modic e de Pfirrmann (p<0,001). CONCLUSÃO: houve uma clara associação entre as classificações estudadas ao se comparar os estágios mais avançados de Pfirrmann (IV e V) com Modic tipo 1 e 2.

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Section: Discussionunclassified

Section: Introductionunclassified

Correlação entre as classificações de Pfirrmann e Modic na degeneração do disco intervertebral lombar

et al. 2010

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“…All MRI parameters were recorded by computer-based measurements, and all calculations were performed with the MRI Analyzer anatomical software (version 3, Truemetric Corp.) for objective quantification as described in prior publications. 6,13,19,20 Disc bulging was measured as the extension of the disc beyond the intervertebral space, with a greater value representing greater posterior bulging. 19,20 Spondylolisthesis was measured as the displacement of 1 vertebral body on the adjacent level below in the anterior or posterior direction as observed on the neutral image.…”

Section: Mri Analysismentioning

confidence: 99%

“…6,13,19,20 Disc bulging was measured as the extension of the disc beyond the intervertebral space, with a greater value representing greater posterior bulging. 19,20 Spondylolisthesis was measured as the displacement of 1 vertebral body on the adjacent level below in the anterior or posterior direction as observed on the neutral image. 13 Segmental mobility was measured in terms of translational motion and angular motion (Fig.…”

Section: Mri Analysismentioning

confidence: 99%

Motion characteristics and related factors of Modic changes in the lumbar spine

Hayashi

Daubs

Suzuki

et al. 2015

SPI

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OBJECT Most studies of Modic changes (MCs) have focused on investigating the relationship between MCs and lowback pain, whereas the kinematic characteristics and degenerative disc disease associated with MCs are not well understood. To the authors' knowledge, no previous study has reported on the kinematics of MCs. The purpose of this study was to elucidate the relationship of MCs to segmental motion and degenerative disc disease. METHODS Four hundred fifty symptomatic patients underwent weight-bearing lumbar kinematic MRI in the neutral, flexion, and extension positions. Segmental displacement and intervertebral angles were measured in 3 positions using computer analysis software. Modic changes, disc degeneration, disc bulging, spondylolisthesis, angular motion, and translational motion were recorded, and the relationship of MCs to these factors was analyzed using a logistic regression model. To control the influence of disc degeneration on segmental motion, angular and translational motion were analyzed according to mild and severe disc degeneration stages. The motion characteristics and disc degeneration among types of MCs were also evaluated. RESULTS Multivariate analysis revealed that age, disc degeneration, angular motion, and translational motion were factors significantly related to MCs. In the severe disc degeneration stage, a significant decrease of angular motion and significant increase of translational motion were found in segments with MCs, indicating that a disorder of the endplate had an additional effect on segmental motion. Disc degeneration increased and angular motion decreased significantly and gradually as the type of MC increased. Translational motion was significantly increased with Type 2 MCs. CONCLUSIONS Age, disc degeneration, angular motion, and translational motion were significantly linked to MCs in the lumbar spine. The translational motion of lumbar segments increased with Type 2 MCs, whereas angular motion decreased as the type of MC increased, indicating that Type 2 MCs may have translational instability likely due to degenerative changes. A disorder of the endplates could play an important role in spinal instability.

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“…4 Several studies have evaluated and supported directional preference therapy for lumbar spine pathology. [17][18][19][20][21][22][23] This study evaluated characteristics of NP/R patients and responsiveness to directional preference therapy. Recognizing both the theoretical value of directional preference-matched home exercise performance and the capability of self-management in patient-centered care to improve health outcomes, the investigators conducting this study hypothesized that patient compliance with a prescribed, directional preferencematched home exercise program would improve responsiveness to conservative treatment of NP/R.…”

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confidence: 99%

Factors in Patient Responsiveness to Directional Preference-Matched Treatment of Neck Pain With or Without Upper Extremity Radiation

Holmes

Brazauskas

Cassidy

et al. 2017

Journal of Patient-Centered Research and Reviews

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Journal of Patient-Centered Research and Reviews ( JPCRR) is a peerreviewed scientific journal whose mission is to communicate clinical and bench research findings, with the goal of improving the quality of human health, the care of the individual patient, and the care of populations. Recommended CitationHolmes B, Brazauskas R, Cassidy LD, Wiegand RA. Factors in patient responsiveness to directional preference-matched treatment of neck pain with or without upper extremity radiation. J Patient Cent Res Rev. 2017;4:60-8.

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Dynamic Bulging of Intervertebral Discs in the Degenerative Lumbar Spine

Cited by 68 publications

References 25 publications

Correlação entre as classificações de Pfirrmann e Modic na degeneração do disco intervertebral lombar

Correlação entre as classificações de Pfirrmann e Modic na degeneração do disco intervertebral lombar

Motion characteristics and related factors of Modic changes in the lumbar spine

Factors in Patient Responsiveness to Directional Preference-Matched Treatment of Neck Pain With or Without Upper Extremity Radiation

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