Radiostereometry in lumbar spine research

Axelsson, Paul; Johnsson, Ragnar; Strömqvist, Björn

doi:10.1080/17453690610046495

Cited by 6 publications

(6 citation statements)

References 102 publications

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“…Two 40-degree angulated roentgen tubes were used to provide exposures on 2 separate films. The lumbosacral spine and a combined reference plate and calibration device with tantalum indicators at known positions in front of the film plane were exposed simultaneously (Axelsson et al 2006). Using the Kinema program for computed data processing according to Selvik (1989), the intervertebral translations along the transverse (x-), vertical (y-) and sagittal (z-) axes were calculated.…”

Section: Radiostereometrymentioning

confidence: 99%

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Adjacent segment hypermobility after lumbar spine fusion: No association with progressive degeneration of the segment 5 years after surgery

2007

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Background and purpose Increased intradiscal pressure and relative segmental hypermobility are in vitro observations supporting the idea of increased postoperative load being a reason for progressive degeneration of the free mobile segment adjacent to a lumbar fusion. These mechanisms have been difficult to confirm in clinical studies, and an alternative theory claims instead that the adjacent segment degeneration follows a natural degenerative course in patients who are predisposed. We examined 9 patients 5 years after lumbar fusion, to assess whether relative hypermobility of the segment adjacent to fusion could be correlated to progressive degeneration of the same segment.Patients and methods The 9 patients, all of whom had been treated with a lumbar fusion after a preoperative intervertebral mobility assessment by spinal RSA, were re-examined 5 years after surgery. The intervertebral translations of the vertebra proximal to the fusion were determined by RSA and compared to the mobility of the same lumbar segment before fusion. The disc height and any progressive reduction at the two levels proximal to the one fused were measured on conventional radiographs.Results Adjacent segment mobility 5 years after fusion-expressed as mean transverse, vertical, and sagittal translation of the vertebra proximal to fusionwas not significantly changed compared to the mobility measured before surgery. Increased mobility of the segment seen in 5 individual patients was not associated with progressive degeneration of the same segment or to a poor clinical outcome.

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Section: Radiostereometrymentioning

confidence: 99%

“…A spinal RSA (Axelsson et al 2006) was performed in all patients 2 months after finishing the external fixation test, but prior to the definitive fusion procedure. Tantalum indicators used for the RSA had been implanted by percutaneous technique in connection with the application of the pedicle screws for test fixation.…”

Section: Radiostereometrymentioning

confidence: 99%

Adjacent segment hypermobility after lumbar spine fusion: No association with progressive degeneration of the segment 5 years after surgery

2007

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“…We chose a movement of less than 2 degrees angular rotation and less than 0.7-mm translation from the literature as prerequisite for diagnosis of fusion. 2 3 4 5 Broadly speaking, there was much more agreement in the levels of fusion between the CT assessment and the RSA. These observations would tend to suggest that histology may have incorrectly assessed the number of fused levels, or to put it in another way, histology in our study should not, perhaps, be considered as the gold standard.…”

Section: Discussionmentioning

confidence: 97%

A Comparison of Radiostereometric Analysis and Computed Tomography for the Assessment of Lumbar Spinal Fusion in a Sheep Model

Humadi

Freeman

Moore

et al. 2013

Evidence-Based Spine-Care Journal

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Study Design Prospective animal study. Objective The aim of this animal study is to evaluate the accuracy of radiostereometric analysis (RSA) compared with computed tomographic (CT) scan in the assessment of spinal fusion after anterior lumbar interbody fusion (ALIF) using histology as a gold standard. Methods Three non-adjacent ALIFs (L1–L2, L3–L4, and L5–L6) were performed in nine sheep. The sheep were divided into three groups of three sheep. All the animals were humanely killed immediately after having the last scheduled RSA. The lumbar spine was removed and in vitro fine cut CT and histopathology were performed. Results Using histological assessment as the gold standard for assessing fusion, RSA demonstrated better results (100% sensitivity and 66.7% specificity; positive predictive value [PPV] = 27.3%, negative predictive value [NPV] =100.0%) compared with CT (66.7% sensitivity and 60.0% specificity [PPV = 16.7%, NPV = 93.8%]). Conclusions RSA demonstrated higher sensitivity and specificity when compared with CT. Furthermore, RSA has the advantage of much lower radiation exposure compared with fine cut CT. Further studies are required to see if RSA remains superior to CT scan for the assessment spinal fusion in the clinical setting.Assessment of Class of Evidence (CoE) for individual studies of diagnostic test evaluationMethodological principleStudy design Prospective cohort designX Retrospective cohort design Case–control designBroad spectrum of patients with expected condition a Appropriate reference standard usedXAdequate description of test and reference for replicationXBlinded comparison with appropriate referenceXReference standard performed independently of testXEvidence levelII Note: Blank box indicates criterion not met, could not be determined, or information not reported by author or was not reported. aThis study contained nine animal subjects.

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“…Two popular methods are distortion compensated roentgen analysis (DCRA) and quantitative motion analysis (QMA) [ 19 ]. Three-dimensional (3D) movements of a lumbar segment are provided by biplane radiography with [ 20 ] or without [ 21 ] radiostereometric analysis (RSA) and by computed tomography (CT) scans. RSA techniques with implantation of tantalum beads are an invasive method but currently the most precise method [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

A New CT Method for Assessing 3D Movements in Lumbar Facet Joints and Vertebrae in Patients before and after TDR

Svedmark

Berg

Noz

et al. 2015

BioMed Research International

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This study describes a 3D-CT method for analyzing facet joint motion and vertebral rotation in the lumbar spine after TDR. Ten patients were examined before and then three years after surgery, each time with two CT scans: provoked flexion and provoked extension. After 3D registration, the facet joint 3D translation and segmental vertebral 3D rotation were analyzed at the operated level (L5-S1) and adjacent level (L4-L5). Pain was evaluated using VAS. The median (±SD) 3D movement in the operated level for the left facet joint was 3.2 mm (±1.9 mm) before and 3.5 mm (±1.7 mm) after surgery and for the right facet joint was 3.0 mm (±1.0 mm) before and 3.6 mm (±1.4 mm) after surgery. The median vertebral rotation in the sagittal plane at the operated level was 5.4° (±2.3°) before surgery and 6.8° (±1.7°) after surgery and in the adjacent level was 7.7° (±4.0°) before and 9.2° (±2.7°) after surgery. The median VAS was reduced from 6 (range 5–8) to 3 (range 2–8) in extension and from 4 (range 2–6) to 2 (range 1–3) in flexion.

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Radiostereometry in lumbar spine research

Cited by 6 publications

References 102 publications

Adjacent segment hypermobility after lumbar spine fusion: No association with progressive degeneration of the segment 5 years after surgery

Adjacent segment hypermobility after lumbar spine fusion: No association with progressive degeneration of the segment 5 years after surgery

A Comparison of Radiostereometric Analysis and Computed Tomography for the Assessment of Lumbar Spinal Fusion in a Sheep Model

A New CT Method for Assessing 3D Movements in Lumbar Facet Joints and Vertebrae in Patients before and after TDR

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