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Published in: Skeletal Radiology 6/2009

01-06-2009 | Perspective

Degenerative lumbar intervertebral instability: what is it and how does imaging contribute?

Authors: Antonio Leone, Victor N. Cassar-Pullicino, Giuseppe Guglielmi, Lorenzo Bonomo

Published in: Skeletal Radiology | Issue 6/2009

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Excerpt

Although low back pain (LBP) is the most common rheumatologic symptom that leads to consultation with a general practitioner, the identification of a specific symptomatic cause remains elusive in the majority of patients with mechanical LBP. Degenerative lumbar intervertebral instability as a cause of chronic LBP is an important factor in determining indications for spinal surgery. …
Literature
1.
go back to reference Pope MH, Panjabi M. Biomechanical definitions of spinal instability. Spine 1985; 10: 255–256.CrossRef Pope MH, Panjabi M. Biomechanical definitions of spinal instability. Spine 1985; 10: 255–256.CrossRef
2.
go back to reference Frymoyer JW, Selby DK. Segmental instability: rationale for treatment. Spine 1985; 10: 280–286.CrossRef Frymoyer JW, Selby DK. Segmental instability: rationale for treatment. Spine 1985; 10: 280–286.CrossRef
3.
go back to reference Leone A, Guglielmi G, Cassar-Pullicino VN, Bonomo L. Lumbar intervertebral instability: a review. Radiology 2007; 245: 62–77 (review).CrossRef Leone A, Guglielmi G, Cassar-Pullicino VN, Bonomo L. Lumbar intervertebral instability: a review. Radiology 2007; 245: 62–77 (review).CrossRef
4.
go back to reference Kirkaldy-Willis WH, Farfan HF. Instability of the lumbar spine. Clin Orthop Relat Res 1982; 165: 110–123. Kirkaldy-Willis WH, Farfan HF. Instability of the lumbar spine. Clin Orthop Relat Res 1982; 165: 110–123.
5.
go back to reference Dupuis PR, Yong-Hing K, Cassidy JD, Kirkaldy-Willis WH. Radiological diagnosis of degenerative lumbar spinal instability. Spine 1985; 10: 262–266.CrossRef Dupuis PR, Yong-Hing K, Cassidy JD, Kirkaldy-Willis WH. Radiological diagnosis of degenerative lumbar spinal instability. Spine 1985; 10: 262–266.CrossRef
6.
go back to reference Fujiwara A, Lim TH, An HS, et al. The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine 2000; 25: 3036–3044.CrossRef Fujiwara A, Lim TH, An HS, et al. The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine 2000; 25: 3036–3044.CrossRef
7.
go back to reference Grobler LJ, Robertson PA, Novotny JE, Pope MH. Etiology of spondylolisthesis: assessment of the role played by lumbar facet joints morphology. Spine 1993; 18: 80–92.CrossRef Grobler LJ, Robertson PA, Novotny JE, Pope MH. Etiology of spondylolisthesis: assessment of the role played by lumbar facet joints morphology. Spine 1993; 18: 80–92.CrossRef
8.
go back to reference Vogt MT, Rubin D, Valentin RS, et al. Lumbar olisthesis and lower back symptoms in elderly white women: the study of osteoporotic fractures. Spine 1998; 23: 2640–2647.CrossRef Vogt MT, Rubin D, Valentin RS, et al. Lumbar olisthesis and lower back symptoms in elderly white women: the study of osteoporotic fractures. Spine 1998; 23: 2640–2647.CrossRef
9.
go back to reference Soini J, Antti-Poika I, Tallroth K, Konttinen YT, Honkanen V, Santavirta S. Disc degeneration and angular movement of the lumbar spine comparative study using plain and flexion–extension radiography and discography. J Spinal Disord 1991; 4: 183–187.CrossRef Soini J, Antti-Poika I, Tallroth K, Konttinen YT, Honkanen V, Santavirta S. Disc degeneration and angular movement of the lumbar spine comparative study using plain and flexion–extension radiography and discography. J Spinal Disord 1991; 4: 183–187.CrossRef
10.
go back to reference Murata M, Morio Y, Kuranobu K. Lumbar disc degeneration and segmental instability: a comparison of magnetic resonance imaging and plain radiographs of patients with low back pain. Arch Orthop Trauma Surg 1994; 113: 297–301.CrossRef Murata M, Morio Y, Kuranobu K. Lumbar disc degeneration and segmental instability: a comparison of magnetic resonance imaging and plain radiographs of patients with low back pain. Arch Orthop Trauma Surg 1994; 113: 297–301.CrossRef
11.
go back to reference Panjabi MM, White AA III. Physical properties and functional mechanics of the spine. In: White AA III, Panjabi MM, editors. Clinical biomechanics of the spine. Philadelphia, PA: Lippincott; 1978. p. 1–60. Panjabi MM, White AA III. Physical properties and functional mechanics of the spine. In: White AA III, Panjabi MM, editors. Clinical biomechanics of the spine. Philadelphia, PA: Lippincott; 1978. p. 1–60.
12.
go back to reference Pitkanen MT, Manninen HI, Lindgren KA, Sihvonen TA, Airaksinen O, Soimakallio S. Segmental lumbar spine instability at flexion–extension radiography can be predicted by conventional radiography. Clin Radiol 2002; 57: 632–639.CrossRef Pitkanen MT, Manninen HI, Lindgren KA, Sihvonen TA, Airaksinen O, Soimakallio S. Segmental lumbar spine instability at flexion–extension radiography can be predicted by conventional radiography. Clin Radiol 2002; 57: 632–639.CrossRef
13.
go back to reference Pitkanen M, Manninen HI. Sidebending versus flexion–extension radiographs in lumbar spinal instability. Clin Radiol 1994; 49: 109–114.CrossRef Pitkanen M, Manninen HI. Sidebending versus flexion–extension radiographs in lumbar spinal instability. Clin Radiol 1994; 49: 109–114.CrossRef
14.
go back to reference Nizard RS, Wybler M, Laredo JD. Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis. Radiol Clin North Am 2001; 39: 55–71.CrossRef Nizard RS, Wybler M, Laredo JD. Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis. Radiol Clin North Am 2001; 39: 55–71.CrossRef
15.
go back to reference Wood KB, Popp CA, Transfeldt EE, Geissele AE. Radiographic evaluation of instability in spondylolisthesis. Spine 1994; 19: 1697–1703.CrossRef Wood KB, Popp CA, Transfeldt EE, Geissele AE. Radiographic evaluation of instability in spondylolisthesis. Spine 1994; 19: 1697–1703.CrossRef
16.
go back to reference McGregor AH, McCarthy ID, Hughes SP. Motion characteristics of the lumbar spine in the normal population. Spine 1995; 20: 2421–2428.CrossRef McGregor AH, McCarthy ID, Hughes SP. Motion characteristics of the lumbar spine in the normal population. Spine 1995; 20: 2421–2428.CrossRef
17.
go back to reference Morgan FP, King T. Primary instability of lumbar vertebrae as a common cause of low back pain. J Bone Jt Surg Br 1957; 39–B: 6–22.CrossRef Morgan FP, King T. Primary instability of lumbar vertebrae as a common cause of low back pain. J Bone Jt Surg Br 1957; 39–B: 6–22.CrossRef
18.
go back to reference Shaffer WO, Spratt KF, Weinstein J, Lehmann TR, Goel V. The consistency and accuracy of roentgenograms for measuring sagittal translation in the lumbar vertebral motion segment. Spine 1990; 15: 741–750.PubMed Shaffer WO, Spratt KF, Weinstein J, Lehmann TR, Goel V. The consistency and accuracy of roentgenograms for measuring sagittal translation in the lumbar vertebral motion segment. Spine 1990; 15: 741–750.PubMed
19.
go back to reference Posner I, White AA 3rd, Edwards WT, Hayes WC. A biomechanical analysis of the clinical stability of the lumbar and lumbosacral spine. Spine 1982; 7: 374–389.CrossRef Posner I, White AA 3rd, Edwards WT, Hayes WC. A biomechanical analysis of the clinical stability of the lumbar and lumbosacral spine. Spine 1982; 7: 374–389.CrossRef
20.
go back to reference Dvorak J, Panjabi MM, Chang D, Theiler R, Grob D. Functional radiographic diagnosis of the lumbar spine: flexion–extension and lateral bending. Spine 1991; 16: 562–571.CrossRef Dvorak J, Panjabi MM, Chang D, Theiler R, Grob D. Functional radiographic diagnosis of the lumbar spine: flexion–extension and lateral bending. Spine 1991; 16: 562–571.CrossRef
21.
go back to reference Trammell TR, Schroeder RD, Reed DB. Rotatory olisthesis in idiopathic scoliosis. Spine 1988; 13: 1378–1382.CrossRef Trammell TR, Schroeder RD, Reed DB. Rotatory olisthesis in idiopathic scoliosis. Spine 1988; 13: 1378–1382.CrossRef
22.
go back to reference Lang P, Chafetz N, Genant HK, Morris JM. Lumbar spinal fusion: assessment of functional stability with magnetic resonance imaging. Spine 1990; 15: 581–588.CrossRef Lang P, Chafetz N, Genant HK, Morris JM. Lumbar spinal fusion: assessment of functional stability with magnetic resonance imaging. Spine 1990; 15: 581–588.CrossRef
23.
go back to reference Bram J, Zanetti M, Min K, Jodler J. MR abnormalities of the intervertebral disks and adjacent bone marrow as predictors of segmental instability of the lumbar spine. Acta Radiol 1998; 39: 18–23.CrossRef Bram J, Zanetti M, Min K, Jodler J. MR abnormalities of the intervertebral disks and adjacent bone marrow as predictors of segmental instability of the lumbar spine. Acta Radiol 1998; 39: 18–23.CrossRef
24.
go back to reference Carragee EJ, Paragioudakis SJ, Khurana S. 2000 Volvo Award winner in clinical studies: lumbar high-intensity zone and discography in subjects without low back problems. Spine 2000; 25: 2987–2992.CrossRef Carragee EJ, Paragioudakis SJ, Khurana S. 2000 Volvo Award winner in clinical studies: lumbar high-intensity zone and discography in subjects without low back problems. Spine 2000; 25: 2987–2992.CrossRef
25.
go back to reference Saifuddin A, Blease S, Macsweeney E. Axial loaded MRI of the lumbar spine. Clin Radiol 2003; 58: 661–671.CrossRef Saifuddin A, Blease S, Macsweeney E. Axial loaded MRI of the lumbar spine. Clin Radiol 2003; 58: 661–671.CrossRef
26.
go back to reference Weishaupt D, Schmid MR, Zanetti M, et al. Positional MR imaging of the lumbar spine: does it demonstrate nerve root compromise not visible at conventional MR imaging? Radiology 2000; 215: 247–253.CrossRef Weishaupt D, Schmid MR, Zanetti M, et al. Positional MR imaging of the lumbar spine: does it demonstrate nerve root compromise not visible at conventional MR imaging? Radiology 2000; 215: 247–253.CrossRef
27.
go back to reference Wildermuth S, Zanetti M, Duewell S, et al. Lumbar spine: quantitative and qualitative assessment of positional (upright flexion and extension) MR imaging and myelography. Radiology 1998; 207: 391–398.CrossRef Wildermuth S, Zanetti M, Duewell S, et al. Lumbar spine: quantitative and qualitative assessment of positional (upright flexion and extension) MR imaging and myelography. Radiology 1998; 207: 391–398.CrossRef
28.
go back to reference Johnsson R, Axelsson P, Stromqvist B. Posterolateral lumbar fusion using facet joint fixation with biodegradable rods: a pilot study. Eur Spine J 1997; 6: 144–148.CrossRef Johnsson R, Axelsson P, Stromqvist B. Posterolateral lumbar fusion using facet joint fixation with biodegradable rods: a pilot study. Eur Spine J 1997; 6: 144–148.CrossRef
29.
go back to reference Leivseth G, Brinckman N, Frobin W, Johnsson R, Stromqvist B. Assessment of sagittal segmental motion in the lumbar spine: a comparison between distortion-compensated and stereophotogrammetric roentgen analysis. Spine 1998; 23: 2648–2655.CrossRef Leivseth G, Brinckman N, Frobin W, Johnsson R, Stromqvist B. Assessment of sagittal segmental motion in the lumbar spine: a comparison between distortion-compensated and stereophotogrammetric roentgen analysis. Spine 1998; 23: 2648–2655.CrossRef
30.
go back to reference Dvorak J, Panjabi MM, Novotny JE, Chang DG, Grob D. Clinical validation of functional flexion–extension roentgenograms of the lumbar spine. Spine 1991; 16: 943–950.CrossRef Dvorak J, Panjabi MM, Novotny JE, Chang DG, Grob D. Clinical validation of functional flexion–extension roentgenograms of the lumbar spine. Spine 1991; 16: 943–950.CrossRef
31.
go back to reference Iguchi T, Kanemura A, Kasahara K, et al. Lumbar instability and clinical symptoms: which is the more critical factor for symptoms: sagittal translation or segment angulation. J Spinal Disord Tech 2004; 17: 284–290.CrossRef Iguchi T, Kanemura A, Kasahara K, et al. Lumbar instability and clinical symptoms: which is the more critical factor for symptoms: sagittal translation or segment angulation. J Spinal Disord Tech 2004; 17: 284–290.CrossRef
32.
go back to reference Hanley EN Jr. The indications for lumbar spinal fusion with and without instrumentation. Spine 1995; 20(24 suppl): 143S–153S.PubMed Hanley EN Jr. The indications for lumbar spinal fusion with and without instrumentation. Spine 1995; 20(24 suppl): 143S–153S.PubMed
33.
go back to reference Markwalder TM, Wenger M. Dynamic stabilization of lumbar motion segments by use of Graf’s ligaments: results with an average follow-up of 7.4 years in 39 highly selected, consecutive patients. Acta Neurochir (Wien) 2003; 145: 209–214.CrossRef Markwalder TM, Wenger M. Dynamic stabilization of lumbar motion segments by use of Graf’s ligaments: results with an average follow-up of 7.4  years in 39 highly selected, consecutive patients. Acta Neurochir (Wien) 2003; 145: 209–214.CrossRef
34.
go back to reference Sears W. Posterior lumbar interbody fusion for degenerative spondylolisthesis: restoration of sagittal balance using insert-and-rotate interbody spacers. Spine J 2005; 5: 170–179.CrossRef Sears W. Posterior lumbar interbody fusion for degenerative spondylolisthesis: restoration of sagittal balance using insert-and-rotate interbody spacers. Spine J 2005; 5: 170–179.CrossRef
35.
go back to reference Fairbank JC, Couper J, Davies JB, O’Brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy 1980; 66: 271–273.PubMed Fairbank JC, Couper J, Davies JB, O’Brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy 1980; 66: 271–273.PubMed
36.
go back to reference Garratt AM, Ruta DA, Abdalla MI, Buckingham JK, Russell IT. The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS. BMJ 1993; 306: 1440–1444.CrossRef Garratt AM, Ruta DA, Abdalla MI, Buckingham JK, Russell IT. The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS. BMJ 1993; 306: 1440–1444.CrossRef
37.
go back to reference Main CJ, Wood PLR, Hollis S, Spanswick CC, Waddell G. The distress and risk assessment method: a simple patient classification to identify distress and evaluate the risk of poor outcome. Spine 1992; 17: 42–52.CrossRef Main CJ, Wood PLR, Hollis S, Spanswick CC, Waddell G. The distress and risk assessment method: a simple patient classification to identify distress and evaluate the risk of poor outcome. Spine 1992; 17: 42–52.CrossRef
38.
go back to reference Nachemson AL. Instability of the lumbar spine: pathology, treatment, and clinical evaluation. Neurosurg Clin N Am 1991; 2: 785–790.CrossRef Nachemson AL. Instability of the lumbar spine: pathology, treatment, and clinical evaluation. Neurosurg Clin N Am 1991; 2: 785–790.CrossRef
Metadata
Title
Degenerative lumbar intervertebral instability: what is it and how does imaging contribute?
Authors
Antonio Leone
Victor N. Cassar-Pullicino
Giuseppe Guglielmi
Lorenzo Bonomo
Publication date
01-06-2009
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 6/2009
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-009-0646-5

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