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Published in: European Spine Journal 2/2013

01-02-2013 | Original Article

Motion characteristics of the vertebral segments with lumbar degenerative spondylolisthesis in elderly patients

Authors: Jun Miao, Shaobai Wang, Zongmiao Wan, Won Man Park, Qun Xia, Kirkham Wood, Guoan Li

Published in: European Spine Journal | Issue 2/2013

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Abstract

Objective

Although some studies have reported on the kinematics of the lumbar segments with degenerative spondylolisthesis (DS), few data have been reported on the in vivo 6 degree-of-freedom kinematics of different anatomical structures of the diseased levels under physiological loading conditions. This research is to study the in vivo motion characteristics of the lumbar vertebral segments with L4 DS during weight-bearing activities.

Methods

Nine asymptomatic volunteers (mean age 54.4) and 9 patients with L4 DS (mean age 73.4) were included. Vertebral kinematics was obtained using a combined MRI/CT and dual fluoroscopic imaging technique. During functional postures (supine, standing upright, flexion, and extension), disc heights, vertebral motion patterns and instability were compared between the two groups.

Results

Although anterior disc heights were smaller in the DS group than in the normal group, the differences were only significant at standing upright. Posterior disc heights were significantly smaller in DS group than in the normal group under all postures. Different vertebral motion patterns were observed in the DS group, especially in the left–right and cranial–caudal directions during flexion and extension of the body. However, the range of motions of the both groups were much less than the reported criteria of lumbar spinal instability.

Conclusion

The study showed that lumbar vertebra with DS has disordered motion patterns. DS did not necessary result in vertebral instability. A restabilization process may have occurred and surgical treatment should be planned accordingly.
Literature
1.
go back to reference Iguchi T, Wakami T, Kurihara A et al (2002) Lumbar multilevel degenerative spondylolisthesis: radiological evaluation and factors related to anterolisthesis and retrolisthesis. J Spinal Disord Tech 15:93–99PubMedCrossRef Iguchi T, Wakami T, Kurihara A et al (2002) Lumbar multilevel degenerative spondylolisthesis: radiological evaluation and factors related to anterolisthesis and retrolisthesis. J Spinal Disord Tech 15:93–99PubMedCrossRef
2.
go back to reference Sengupta DK, Herkowitz HN (2005) Degenerative spondylolisthesis: review of current trends and controversies. Spine 15:S71–S81CrossRef Sengupta DK, Herkowitz HN (2005) Degenerative spondylolisthesis: review of current trends and controversies. Spine 15:S71–S81CrossRef
3.
go back to reference Berlemann U, Jeszenszky DJ, Bühler DW et al (1999) The role of lumbar lordosis, vertebral end-plate inclination, disc height, and facet orientation in degenerative spondylolisthesis. J Spinal Disord 12:68–73PubMedCrossRef Berlemann U, Jeszenszky DJ, Bühler DW et al (1999) The role of lumbar lordosis, vertebral end-plate inclination, disc height, and facet orientation in degenerative spondylolisthesis. J Spinal Disord 12:68–73PubMedCrossRef
4.
go back to reference Nagaosa Y, Kikuchi S, Hasue M et al (1998) Pathoanatomic mechanisms of degenerative spondylolisthesis. A radiographic study. Spine 23:1447–1451PubMedCrossRef Nagaosa Y, Kikuchi S, Hasue M et al (1998) Pathoanatomic mechanisms of degenerative spondylolisthesis. A radiographic study. Spine 23:1447–1451PubMedCrossRef
5.
go back to reference Kalichman L, Hunter DJ, Kim DH et al (2009) Association between disc degeneration and degenerative spondylolisthesis? Pilot study. J Back Musculoskelet Rehabil 22:21–25PubMed Kalichman L, Hunter DJ, Kim DH et al (2009) Association between disc degeneration and degenerative spondylolisthesis? Pilot study. J Back Musculoskelet Rehabil 22:21–25PubMed
6.
go back to reference Varlotta GP, Lefkowitz TR, Schweitzer M et al (2011) The lumbar facet joint: a review of current knowledge: part 1: anatomy, biomechanics, and grading. Skeletal Radiol 40:13–23PubMedCrossRef Varlotta GP, Lefkowitz TR, Schweitzer M et al (2011) The lumbar facet joint: a review of current knowledge: part 1: anatomy, biomechanics, and grading. Skeletal Radiol 40:13–23PubMedCrossRef
7.
go back to reference Chen IR, Wei TS (2009) Disc height and lumbar index as independent predictors of degenerative spondylolisthesis in middle-aged women with low back pain. Spine 34:1402–1409PubMedCrossRef Chen IR, Wei TS (2009) Disc height and lumbar index as independent predictors of degenerative spondylolisthesis in middle-aged women with low back pain. Spine 34:1402–1409PubMedCrossRef
8.
go back to reference Luk KD, Chow DH, Holmes A (2003) Vertical instability in spondylolisthesis: a traction radiographic assessment technique and the principle of management. Spine 28:819–827PubMed Luk KD, Chow DH, Holmes A (2003) Vertical instability in spondylolisthesis: a traction radiographic assessment technique and the principle of management. Spine 28:819–827PubMed
9.
go back to reference Hong SW, Lee HY, Kim KH et al (2010) Interspinous ligamentoplasty in the treatment of degenerative spondylolisthesis: midterm clinical results. J Neurosurg Spine 13:27–35PubMedCrossRef Hong SW, Lee HY, Kim KH et al (2010) Interspinous ligamentoplasty in the treatment of degenerative spondylolisthesis: midterm clinical results. J Neurosurg Spine 13:27–35PubMedCrossRef
10.
go back to reference Cho BY, Murovic JA, Park J (2009) Imaging correlation of the degree of degenerative L4–5 spondylolisthesis with the corresponding amount of facet fluid. J Neurosurg Spine 11:614–619PubMedCrossRef Cho BY, Murovic JA, Park J (2009) Imaging correlation of the degree of degenerative L4–5 spondylolisthesis with the corresponding amount of facet fluid. J Neurosurg Spine 11:614–619PubMedCrossRef
11.
12.
go back to reference Takayanagi K, Takahashi K, Yamagata M et al (2001) Using cineradiography for continuous dynamic-motion analysis of the lumbar spine. Spine 26:1858–1865PubMedCrossRef Takayanagi K, Takahashi K, Yamagata M et al (2001) Using cineradiography for continuous dynamic-motion analysis of the lumbar spine. Spine 26:1858–1865PubMedCrossRef
13.
go back to reference Okawa A, Shinomiya K, Komori H et al (1998) Dynamic motion study of the whole lumbar spine by videofluoroscopy. Spine 23:1743–1749PubMedCrossRef Okawa A, Shinomiya K, Komori H et al (1998) Dynamic motion study of the whole lumbar spine by videofluoroscopy. Spine 23:1743–1749PubMedCrossRef
14.
go back to reference McGregor AH, Anderton L, Gedroyc WM et al (2002) The use of interventional open MRI to assess the kinematics of the lumbar spine in patients with spondylolisthesis. Spine 27:1582–1586PubMedCrossRef McGregor AH, Anderton L, Gedroyc WM et al (2002) The use of interventional open MRI to assess the kinematics of the lumbar spine in patients with spondylolisthesis. Spine 27:1582–1586PubMedCrossRef
15.
go back to reference Huang KY, Lin RM, Lee YL et al (2009) Factors affecting disability and physical function in degenerative lumbar spondylolisthesis of L4–5: evaluation with axially loaded MRI. Eur Spine J 18:1851–1857PubMedCrossRef Huang KY, Lin RM, Lee YL et al (2009) Factors affecting disability and physical function in degenerative lumbar spondylolisthesis of L4–5: evaluation with axially loaded MRI. Eur Spine J 18:1851–1857PubMedCrossRef
16.
go back to reference Li G, Wang S, Passias P et al (2009) Segmental in vivo vertebral motion during functional human lumbar spine activities. Eur Spine J 18:1013–1021PubMedCrossRef Li G, Wang S, Passias P et al (2009) Segmental in vivo vertebral motion during functional human lumbar spine activities. Eur Spine J 18:1013–1021PubMedCrossRef
17.
go back to reference Xia Q, Wang S, Kozanek M et al (2010) In vivo motion characteristics of lumbar vertebrae in sagittal and transverse planes. J Biomech 43:1905–1909PubMedCrossRef Xia Q, Wang S, Kozanek M et al (2010) In vivo motion characteristics of lumbar vertebrae in sagittal and transverse planes. J Biomech 43:1905–1909PubMedCrossRef
18.
go back to reference Wang S, Passias P, Li G, Wood K (2008) Measurement of vertebral kinematics using noninvasive image matching method-validation and application. Spine 33:E355–E361PubMedCrossRef Wang S, Passias P, Li G, Wood K (2008) Measurement of vertebral kinematics using noninvasive image matching method-validation and application. Spine 33:E355–E361PubMedCrossRef
19.
go back to reference Pfirrmann CW, Metzdorf A, Elfering A et al (2006) Effect of aging and degeneration on disc volume and shape: a quantitative study in asymptomatic volunteers. J Orthop Res 24:1086–1094PubMedCrossRef Pfirrmann CW, Metzdorf A, Elfering A et al (2006) Effect of aging and degeneration on disc volume and shape: a quantitative study in asymptomatic volunteers. J Orthop Res 24:1086–1094PubMedCrossRef
20.
go back to reference Vogt MT, Rubin DA, Palermo L et al (2003) Lumbar spine listhesis in older African American women. Spine J 3:255–261PubMedCrossRef Vogt MT, Rubin DA, Palermo L et al (2003) Lumbar spine listhesis in older African American women. Spine J 3:255–261PubMedCrossRef
21.
go back to reference Bolesta MJ, Bohlman HH (1989) Degenerative spondylolisthesis. Instr Course Lect 38:157–165PubMed Bolesta MJ, Bohlman HH (1989) Degenerative spondylolisthesis. Instr Course Lect 38:157–165PubMed
22.
go back to reference Fujiwara A, Tamai K, An HS et al (2000) The relationship between disc degeneration, facet joint osteoarthritis, and stability of the degenerative lumbar spine. J Spinal Disord 13:444–450PubMedCrossRef Fujiwara A, Tamai K, An HS et al (2000) The relationship between disc degeneration, facet joint osteoarthritis, and stability of the degenerative lumbar spine. J Spinal Disord 13:444–450PubMedCrossRef
23.
go back to reference Chagnon A, Aubin CE, Villemure I (2010) Biomechanical influence of disk properties on the load transfer of healthy and degenerated disks using a poroelastic finite element model. J Biomech Eng 132:111006PubMedCrossRef Chagnon A, Aubin CE, Villemure I (2010) Biomechanical influence of disk properties on the load transfer of healthy and degenerated disks using a poroelastic finite element model. J Biomech Eng 132:111006PubMedCrossRef
24.
go back to reference Dai L, Jia L (1996) Role of facet asymmetry in lumbar spine disorders. Acta Orthop Belg 62:90–93PubMed Dai L, Jia L (1996) Role of facet asymmetry in lumbar spine disorders. Acta Orthop Belg 62:90–93PubMed
25.
go back to reference Toyone T, Ozawa T, Kamikawa K et al (2009) Facet joint orientation difference between cephalad and caudad portions: a possible cause of degenerative spondylolisthesis. Spine 34:2259–2262PubMedCrossRef Toyone T, Ozawa T, Kamikawa K et al (2009) Facet joint orientation difference between cephalad and caudad portions: a possible cause of degenerative spondylolisthesis. Spine 34:2259–2262PubMedCrossRef
26.
go back to reference Ramsbacher J, Theallier-Janko A, Stoltenburg-Didinger G et al (2001) Ultrastructural changes in paravertebral muscles associated with degenerative spondylolisthesis. Spine 26:2180–2185PubMedCrossRef Ramsbacher J, Theallier-Janko A, Stoltenburg-Didinger G et al (2001) Ultrastructural changes in paravertebral muscles associated with degenerative spondylolisthesis. Spine 26:2180–2185PubMedCrossRef
27.
go back to reference Alqarni AM, Schneiders AG, Hendrick PA (2011) Clinical tests to diagnose lumbar segmental instability: a systematic review. J Orthop Sports Phys Ther 41:130–140PubMed Alqarni AM, Schneiders AG, Hendrick PA (2011) Clinical tests to diagnose lumbar segmental instability: a systematic review. J Orthop Sports Phys Ther 41:130–140PubMed
28.
go back to reference Hasegewa K, Kitahara K, Hara T, Takano K, Shimoda H (2009) Biomechanical evaluation of segmental instability in degenerative lumbar spondylolisthesis. Eur Spine J 18(4):465–470PubMedCrossRef Hasegewa K, Kitahara K, Hara T, Takano K, Shimoda H (2009) Biomechanical evaluation of segmental instability in degenerative lumbar spondylolisthesis. Eur Spine J 18(4):465–470PubMedCrossRef
29.
go back to reference Kirkaldy-Willis WH, Farfan HF (1982) Instability of the lumbar spine. Clin Orthop Relat Res 165:110–123PubMed Kirkaldy-Willis WH, Farfan HF (1982) Instability of the lumbar spine. Clin Orthop Relat Res 165:110–123PubMed
30.
go back to reference Nizard RS, Wybier M, Laredo JD (2001) Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis. Radiol Clin North Am 39:55–71 (v–vi)PubMedCrossRef Nizard RS, Wybier M, Laredo JD (2001) Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis. Radiol Clin North Am 39:55–71 (v–vi)PubMedCrossRef
Metadata
Title
Motion characteristics of the vertebral segments with lumbar degenerative spondylolisthesis in elderly patients
Authors
Jun Miao
Shaobai Wang
Zongmiao Wan
Won Man Park
Qun Xia
Kirkham Wood
Guoan Li
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 2/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-012-2428-3

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