Surgical outcomes of degenerative lumbar spondylolisthesis with anterior vacuum disc: Can the intervertebral cage overcome intradiscal vacuum phenomenon and enhance posterolateral fusion?

Liao, Jen‐Chung; Lu, Meng‐Ling; Niu, Chi‐Chien; Chen, Wen-Jer; Chen, Lih-Hui

doi:10.1007/s00776-014-0618-z

Cited by 34 publications

(22 citation statements)

References 22 publications

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“…Both island and linear VP's were signi cant indicators of high-grade degenerative disc changes on MRI. 3 Due to the fact that most patients undergoing spine surgery have received CT imaging and lateral exionextension x-rays for pre-operative surgical guidance, we decided to retrospectively look for the presence of VP on sagittal CT. 22 and use the Murata et al morphologic component of the classi cation system of island (less than 2 mm), spot (greater than 2 mm), and linear morphologies to determine which morphology is correlated with increased dynamic subluxation or loss of disc height on lateral exionextension x-rays. Furthermore, we performed these analyses between patients who have and who have not had previous lumbar surgery.…”

Section: Discussionmentioning

confidence: 99%

CT Classification of Vacuum Phenomenon Morphology and its Utility in Predicting Lumbar Vertebral Instability

Kelm

Hella

Westfall

et al. 2020

Preprint

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Background: Lumbar vacuum phenomenon (VP) within the intervertebral disc has been classified based on CT imaging. We compared same-patient sagittal CT images and dynamic flexion-extension x-rays to determine if there is a difference in the amount of vertebral instability present between three VP morphologies on CT.Methods: Anterior subluxation measurements on x-ray were compared with same-segment VP on CT images from the same patient when both findings were present. VP were classified as spot, island, or linear. It was determined if there was a difference in the amount of anterior subluxation between the three morphologies. Secondary analysis looked at whether there was a difference in anterior subluxation between the three groups if patients had undergone a prior lumbar fusion surgery or not. Results: There was no difference in anterior subluxation between the three groups on dynamic flexion-extension x-rays. There was also no difference between the three groups on flexion-extension x-rays when patients were separated based on if they had received or not received a previous lumbar fusion surgery. Conclusion: IVD VP morphology is not a useful indicator in determining vertebral instability pre-operatively according to CT scan. Further fine-tuning of an IVD VP CT classification is needed to help radiologists and spine surgeons know when IVD VP presence is important.

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Section: Discussionmentioning

confidence: 99%

CT Classification of Vacuum Phenomenon Morphology and its Utility in Predicting Lumbar Vertebral Instability

Kelm

Hella

Westfall

et al. 2020

Preprint

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“…It was concluded that there was no difference in rates of fusion, operative time, EBL, and ODI, SF-36, and VAS outcome measures between procedures. Similarly, Baker et al completed a more recent systemic review including 13 studies, mostly graded as level III evidence [18,32,[39][40][41][42][43][44][45][46][47][48][49]. The authors concluded that there was not sufficient evidence to recommend for or against interbody fusion.…”

Section: Interbody Fusionmentioning

confidence: 99%

Treatment for Degenerative Lumbar Spondylolisthesis: Current Concepts and New Evidence

Samuel

Moore

Cunningham

2017

Curr Rev Musculoskelet Med

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There is some moderate evidence that decompression alone may be a feasible treatment with lower surgical morbidity and similar outcomes to fusion when performed in a select population with a low-grade slip. Similarly, addition of interbody fusion may be best suited to a subset of patients with high-grade degenerative spondylolisthesis, although this remains controversial. Minimally invasive techniques are increasingly being utilized for both decompression and fusion surgeries with more and more studies showing similar outcomes and lower postoperative morbidity for patients. This will likely be an area of continued intense research. Finally, the role of spondylolisthesis reduction will likely be determined as further investigation into optimal sagittal balance and spinopelvic parameters is conducted. Future identification of ideal thresholds for sagittal vertical axis and slip angle that will prevent progression and reoperation will play an important role in surgical treatment planning. Current evidence supports surgical treatment of degenerative spondylolisthesis. While posterolateral spinal fusion remains the treatment of choice, the use of interbodies and decompressions without fusion may be efficacious in certain populations. However, additional high-quality evidence is needed, especially in newer areas of practice such as minimally invasive techniques and sagittal balance correction.

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“…Studies have found that the kyphosis caused by the collapse of intervertebral space in patients with DLS is closely related to their quality of life, and indicated that kyphosis is one of the important factors of low back pain. [9,10] With the further study of spinal biomechanics and sagittal balance, the understanding of DLS pathogenic factors and natural history have been increasingly comprehensive. [11] In recent decades, correlation between spino-pelvic parameters and morbidity of DLS, as well as between spinal sagittal balance and progression of DLS are the hot pots and have been gradually revealed.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and Clinical Significance of Spondylolisthetic and Spino-pelvic Sagittal Parameters in Kyphotic Low-grade Degenerative Lumbar Spondylolisthesis

Yin²,

2020

Preprint

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Background: Degenerative lumbar spondylolisthesis (DLS) has been a common disease that make increasing patients suffer from different degrees of low back pain and radicular symptoms. At present, the incidence of kyphosis in DLS and the differences in spinal sagittal morphology between kyphotic and non-kyphotic DLS still remain unclear. Our study aimed to determine the incidence of kyphosis in DLS, explore the characteristics of spondylolisthetic and spino-pelvic sagittal parameters, and evaluate the impact of kyphosis on the life quality of patients with DLS.Methods/Design: All 108 patients with L4/5 low-grade DLS were enrolled and divided into kyphotic and non-kyphotic group. 2 spine surgeons who have certain clinical experience were selected to measure the spondylolisthetic and spino-pelvic parameters, as well as visual analogue scale (VAS) and Oswestry disability index (ODI). Differences between the 2 groups and characteristics of measurements were analyzed.Results: The inter-observer agreement of all parameters between the 2 spine surgeons were excellent with each ICC > 0.75. Kyphotic group had higher SA, SD, SDM, SAM, PDH, PT and SVA, and lower ADH, SS and LL than those in non-kyphotic group (p < 0.01). There was no significant difference in PI and TK between the two groups (p > 0.05).Conclusion: The incidence of kyphotic spondylolisthesis in patients with L4/5 low-grade DLS is 16.7%. Compared with those in non-kyphotic group, patients with kyphosis show inferior results of spondylolisthetic parameters, more severe loss of LL, more obvious pelvic retroversion and trunk anteversion, which indicates worse spino-pelvic sagittal balance. In addition, their quality of life was significantly lower than that of patients in non-kyphotic group.

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Surgical outcomes of degenerative lumbar spondylolisthesis with anterior vacuum disc: Can the intervertebral cage overcome intradiscal vacuum phenomenon and enhance posterolateral fusion?

Cited by 34 publications

References 22 publications

CT Classification of Vacuum Phenomenon Morphology and its Utility in Predicting Lumbar Vertebral Instability

CT Classification of Vacuum Phenomenon Morphology and its Utility in Predicting Lumbar Vertebral Instability

Treatment for Degenerative Lumbar Spondylolisthesis: Current Concepts and New Evidence

Characteristics and Clinical Significance of Spondylolisthetic and Spino-pelvic Sagittal Parameters in Kyphotic Low-grade Degenerative Lumbar Spondylolisthesis

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