Segmental Roentgenographic Analysis of Vertebral Inclination on Sagittal Plane in Asymptomatic versus Chronic Low Back Pain Patients

Korovessis, Panagiotis; Stamatakis, Marios; Baikousis, Andreas

doi:10.1097/00002517-199904000-00009

Cited by 91 publications

(48 citation statements)

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“…Jackson and McManus (1994) found a significant decrease in lumbar lordosis for the low back pain group compared with normal controls. Results from several other studies support the concept that decreased lumbar lordosis is associated with increased low back pain (Takemitsu et al 1988;Korovessis et al 1999;Barrey et al 2007). Korovessis et al (1999) reported a greater tendency toward increased thoracic kyphosis in the low back pain group than in controls, with significant differences solely in the sixth decade (P < 0.01).…”

Section: Discussionsupporting

confidence: 61%

Spinal Alignment and Mobility in Subjects with Chronic Low Back Pain with Walking Disturbance: A Community-Dwelling Study

Miyakoshi

Kasukawa

Ishikawa

et al. 2010

Tohoku J. Exp. Med.

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Section: Discussionsupporting

confidence: 61%

Spinal Alignment and Mobility in Subjects with Chronic Low Back Pain with Walking Disturbance: A Community-Dwelling Study

Miyakoshi

Kasukawa

Ishikawa

et al. 2010

Tohoku J. Exp. Med.

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“…The exclusion criteria were the following: severe osteoporosis, loss of lumbar lordosis [28], previous lumbar surgery-fracture, lack of motion (ankylosis), UCLA [ II arthritic grade in the adjacent segment cephalad to instrumentation, spondylolisthesis, and acquired spinous process insufficiency.…”

Section: Methodsmentioning

confidence: 99%

“…Although most often the criteria to determine ASD are based solely on radiographic findings [2,7,19,28,30,34,39,41,59] reporting an ASD incidence ranging from 8 to 100%, the symptomatic incidence of ASD is significantly lower ranging from 5.2 to 18.5% [7,28,31], while the rate of re-operation rate for symptomatic ASD ranges from 2.7 to 20% [16,58].…”

Section: Introductionmentioning

confidence: 99%

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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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“…[16][17][18]21,28 In the standing position, a plumb line dropped from the mid-C-7 VB should fall in the region of the dorsal L5-S1 interspace. A negative 2 to 4-cm space behind this region is normal.…”

Section: Principles Of Deformity Correctionmentioning

confidence: 99%

Biomechanics of spinal deformity

Schlenk¹,

Kowalski²,

Benzel³

2003

FOC

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The correction of spinal deformity may be achieved by a variety of methods, each of which has advantages and disadvantages. The goals of spinal deformity surgery include reasonable correction of the curvature, prevention of further deformation, improvement of sagittal and coronal balance, optimization of cosmetic issues, and restoration/preservation of function. The failure to consider all these factors appropriately may result in a suboptimal outcome. Understanding fundamental biomechanical principles involved in the formation, progression, and treatment of spinal deformities is essential in the clinical decision-making process.

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Segmental Roentgenographic Analysis of Vertebral Inclination on Sagittal Plane in Asymptomatic versus Chronic Low Back Pain Patients

Cited by 91 publications

References 0 publications

Spinal Alignment and Mobility in Subjects with Chronic Low Back Pain with Walking Disturbance: A Community-Dwelling Study

Spinal Alignment and Mobility in Subjects with Chronic Low Back Pain with Walking Disturbance: A Community-Dwelling Study

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

Biomechanics of spinal deformity

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