Kinematic analysis of diseased and adjacent segments in degenerative lumbar spondylolisthesis. 2015

Kevin H Phan, and Michael D Daubs, and Asher I Kupperman, and Trevor P Scott, and Jeffrey C Wang
Department of Orthopaedic Surgery, University of California Los Angeles, 1250 16th Street, Suite 3145, Santa Monica, CA 90404, USA. Electronic address: kevinphan87@gmail.com.

BACKGROUND Degenerative spondylolisthesis is a common pathologic condition that leads to lumbar instability and significant clinical symptoms. The effect of this pathology on adjacent lumbar motion segments, however, has not yet been studied. OBJECTIVE To characterize the motion characteristics of lumbar degenerative spondylolisthesis at both the diseased and adjacent levels in patients with low-grade, single-level lumbar degenerative spondylolisthesis using kinetic magnetic resonance imaging (kMRI). METHODS Retrospective study of patient kMRIs. METHODS One-hundred twelve patient MRIs with low-grade, single-level lumbar spondylolisthesis were included. METHODS Angular and translational motion. METHODS This study compared 112 patients diagnosed with low-grade (Grade 1 or 2), single-level lumbar degenerative spondylolisthesis at L3-L4, L4-L5, or L5-S1 with 296 control patients without spondylolisthesis. Angular and translational motion were measured using patient kMRIs. The level of slip was graded according to the Meyerding classification system, and disc degeneration was classified according to the Pfirrmann system. Instability was defined as translational motion greater than 4 mm. RESULTS Lumbar hypomobility was often present regardless of the level of degenerative spondylolisthesis. A slip at L3-L4 resulted in the largest decrease in lumbar range of motion. Instability at the diseased level was most common at L3-L4 (36%), followed by L5-S1 (31%) and L4-L5 (30%). Instability at the adjacent segments was most frequent at L4-L5 (49%), followed by L5-S1 (34%) and L3-L4 (23%). Patients with stable spondylolisthesis generally had decreased angular motion at all lumbar levels. Translational motion at the diseased level was consistently increased. Disc degeneration was significantly greater at the level of slip for the L3-L4 and L4-L5 spondylolisthesis groups and equal to the control group in the L5-S1 group. There was no significant difference in disc degeneration at adjacent segments in L3-L4 and L4-L5 degenerative spondylolisthesis patients, but there was a significant decrease with an L5-S1 slip. CONCLUSIONS There were a similar percentage of patients in each degenerative spondylolisthesis group with lumbar instability. Angular motion decreased at the diseased level with L3-L4 and L5-S1 spondylolisthesis, but increased with L4-L5 spondylolisthesis. Translational motion, however, increased at the diseased level in all three groups. There was compensatory hypermobility at adjacent levels in patients with unstable spondylolisthesis at L3-L4 and L4-L5, but not at L5-S1.

UI MeSH Term Description Entries
D008159 Lumbar Vertebrae VERTEBRAE in the region of the lower BACK below the THORACIC VERTEBRAE and above the SACRAL VERTEBRAE. Vertebrae, Lumbar
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009038 Motion Physical motion, i.e., a change in position of a body or subject as a result of an external force. It is distinguished from MOVEMENT, a process resulting from biological activity. Motions
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001696 Biomechanical Phenomena The properties, processes, and behavior of biological systems under the action of mechanical forces. Biomechanics,Kinematics,Biomechanic Phenomena,Mechanobiological Phenomena,Biomechanic,Biomechanic Phenomenas,Phenomena, Biomechanic,Phenomena, Biomechanical,Phenomena, Mechanobiological,Phenomenas, Biomechanic

Related Publications

Kevin H Phan, and Michael D Daubs, and Asher I Kupperman, and Trevor P Scott, and Jeffrey C Wang
April 2022, Journal of orthopaedic surgery and research,
Kevin H Phan, and Michael D Daubs, and Asher I Kupperman, and Trevor P Scott, and Jeffrey C Wang
December 2014, Zhonghua yi xue za zhi,
Kevin H Phan, and Michael D Daubs, and Asher I Kupperman, and Trevor P Scott, and Jeffrey C Wang
November 2017, Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia,
Kevin H Phan, and Michael D Daubs, and Asher I Kupperman, and Trevor P Scott, and Jeffrey C Wang
February 1997, Harefuah,
Kevin H Phan, and Michael D Daubs, and Asher I Kupperman, and Trevor P Scott, and Jeffrey C Wang
February 2013, European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society,
Kevin H Phan, and Michael D Daubs, and Asher I Kupperman, and Trevor P Scott, and Jeffrey C Wang
October 2016, Orthopaedics & traumatology, surgery & research : OTSR,
Kevin H Phan, and Michael D Daubs, and Asher I Kupperman, and Trevor P Scott, and Jeffrey C Wang
May 1995, Spine,
Kevin H Phan, and Michael D Daubs, and Asher I Kupperman, and Trevor P Scott, and Jeffrey C Wang
January 1992, La Chirurgia degli organi di movimento,
Kevin H Phan, and Michael D Daubs, and Asher I Kupperman, and Trevor P Scott, and Jeffrey C Wang
February 1994, Ugeskrift for laeger,
Kevin H Phan, and Michael D Daubs, and Asher I Kupperman, and Trevor P Scott, and Jeffrey C Wang
April 2008, The Journal of the American Academy of Orthopaedic Surgeons,
Copied contents to your clipboard!