Lumbar Spine Disc Height and Curvature Responses to an Axial Load Generated by a Compression Device Compatible with Magnetic Resonance Imaging

Kimura, Satoshi; Steinbach, Gregory C.; Watenpaugh, Donald E.; Hargens, Alan R.

doi:10.1097/00007632-200112010-00014

Cited by 117 publications

(78 citation statements)

References 27 publications

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“…Others have additionally used advanced imaging techniques as computed tomography (CT), magnetic resonance imaging (MRI) [13,25,53,63]. In this study, we used the ''statistic'' radiographic criteria (UCLA arthritic grading system) that has been successfully used by others [15] along with dynamic motion parameters for the cephalad ASD (ROM, olisthesis).…”

Section: Discussionmentioning

confidence: 99%

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%

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

et al. 2009

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“…For a detailed description of the vertebral body and intervertebral disc geometry evaluation, as well as rationalization of this measurements, please see Vialle et al [5], Been et al [18], De Carvalho [19] and Kimura et al [20]. For each of the five lumbar vertebrae, two lines were drawn: along the superior endplate of the vertebral body (also on the first sacral vertebra) and along the inferior endplate of the vertebral body (Fig.…”

Section: Spondylolysis and Spondylolisthesis Evaluationmentioning

confidence: 99%

Geometry of the vertebral bodies and the intervertebral discs in lumbar segments adjacent to spondylolysis and spondylolisthesis: pilot study

Been

Hunter

et al. 2010

Eur Spine J

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The objective is to evaluate the geometric parameters of vertebral bodies and intervertebral discs in spinal segments adjacent to spondylolysis and spondylolisthesis. This pilot cross-sectional study was an ancillary project to the Framingham Heart Study. The presence of spondylolysis and spondylolisthesis as well as measurements of spinal geometry were identified on CT imaging of 188 individuals. Spinal geometry measurements included lordosis angle, wedging of each lumbar vertebra and intervertebral disc. Last measurements were used to calculate RB, the sum of the lumbar L1-L5 body wedge angles; and RD, the sum of the lumbar L1-L5 intervertebral disc angles. Using Wilcoxon-Mann-Whitney test we compared the geometric parameters between individuals with no pathology and ones with spondylolysis (with no listhesis) at L5 vertebra, ones with isthmic spondylolisthesis at L5-S1 level, and ones with degenerative spondylolisthesis at L5-S1 level. Spinal geometry in individuals with spondylolysis or listhesis at L5 shows three major patterns: In spondylolysis without listhesis, spinal morphology is similar to that of healthy individuals; In isthmic spondylolisthesis there is high lordosis angle, high L5 vertebral body wedging and very high L4-5 disc wedging; In degenerative spondylolisthesis, spinal morphology shows more lordotic wedging of the L5 vertebral body, and less lordotic wedging of intervertebral discs. In conclusion, there are unique geometrical features of the vertebrae and discs in spondylolysis or listhesis. These findings need to be reproduced in larger scale study.

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“…The lumbar lordosis of L4-5 HNP patients was a (p<0.05), which revealed a smaller angle than the normal lumbar lordosis. 13) Kimura et al study imposed a load of 50% of body weight on each of 8 young subjects from the shoulder toward the feet and measured the lumbar spine angles and disc heights before loading and under load using MRI 8) . Based on the results, they reported that whereas the lumbar spine angles between L4-5 did not change, the disc heights between L4-5 significantly decreased, indicating that pressures in the vertical directions would results in decreased disc heights.…”

Section: Discussionmentioning

confidence: 99%

“…To measure L4-5 disc angles, we drew a extended line backward on the top surface of the pyramid of the lumbar spine 6 from the lateral lumbar spine. Then, we drew a extended line on the bottom surface of the lumbar spine 4 backward and name the angle of the crossing angle of the 2 lines, B, and measure it for comparison 8) . To measure L4-5 disc heights, the disc heights of the front part, the middle part, and the rear part were measured on the lateral lumbar spine and the heights were averaged and divided by 3: The formula for disc height measurements is (a+b+c)/3(mm) 10) .…”

Section: Methodsmentioning

confidence: 99%

“…Previous studies using radiography included those using radiography conducted on the lumbar lordosis of normal persons or back pain patients 4) , lumbar lordosis of pregnant women 5) , lumbar lordosis in relation to the height of shoe heels 6) , lumbar lordosis before and after exercises for stabilizing the lumbar region. Previous studies using MRI are limited to a study on lumbar lordosis and the lumbosacral angle before and after disc surgery 7) , and a study on L4-5 lumbar angle and disc height 8) .…”

Section: Introductionmentioning

confidence: 99%

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The Correlations between Lumbar Lordosis, L4-5 Disc Angle, L4-5 Disc Height, and the Lumbosacral Angle in L4-5 HNP Patients

Ma¹,

Gong

2010

J Phys Ther Sci

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Abstract. [Purpose] This study was conducted to examine the degree of lumbar lordosis, L 4-5 disc angle, L 4-5 disc height and the lumbosacral angle in L 4-5 herniated nucleus pulposus (HNP) patients and analyze the correlations between these variables to examine the relationship between HNP and abnormal sagittal spinal alignment.[Subjects] The study subjects were 15 lumbar spine 4-5 (L 4-5 ) HNP patients; the control group comprised 15 normal adults. [Methods] Both groups' magnetic resonance imaging scans were compared and analyzed.[Results] The HNP group showed a significantly smaller degree of lumbar lordosis, L 4-5 disc angle, L 4-5 disc height, and lumbosacral angle (p<0.05). I was also shown that as the degree of lumbar lordosis decreased, the disc angle, disc height, and lumbosacral angle decreased.[Conclusion] We found that L 4-5 HNP patients have abnormal sagittal spinal alignments.

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Lumbar Spine Disc Height and Curvature Responses to an Axial Load Generated by a Compression Device Compatible with Magnetic Resonance Imaging

Abstract: The axial force of 50% body weight in supine posture simulates the upright lumbar spine morphologically. No change in intervertebral angle occurred at L4-L5. However, disc height at L4-L5 decreased significantly during compression.

Cited by 117 publications

References 27 publications

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

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

Geometry of the vertebral bodies and the intervertebral discs in lumbar segments adjacent to spondylolysis and spondylolisthesis: pilot study

The Correlations between Lumbar Lordosis, L4-5 Disc Angle, L4-5 Disc Height, and the Lumbosacral Angle in L4-5 HNP Patients

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