Neurospine

Image-Based Markers Predict Dynamic Instability in Lumbar Degenerative Spondylolisthesis: William Slikker III, Alejandro A. Espinoza Orías, Grant D. Shifflett, Joe Y.B. Lee, Krzysztof Siemionow, Sapan Gandhi, Louis Fogg, Dino Samartzis, Nozomu Inoue, Howard S. An; Neurospine 2020;17(1):221-227. Published online March 31, 2020; DOI: https://doi.org/10.14245/ns.1938440.220

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Image-Based Markers Predict Dynamic Instability in Lumbar Degenerative Spondylolisthesis

Neurospine. 2020;17(1):221-227. Published online March 31, 2020

DOI: https://doi.org/10.14245/ns.1938440.220

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Image-Based Markers Predict Dynamic Instability in Lumbar Degenerative Spondylolisthesis

Neurospine. 2020;17(1):221-227. Published online March 31, 2020

DOI: https://doi.org/10.14245/ns.1938440.220

Objective
To identify possible radiographic predictors markers of dynamic instability including disc height (DH), disc degeneration, and spondylosis in the setting of degenerative spondylolisthesis (DS).
Methods
A retrospective review with prospectively collected data was performed on 125 patients with L4–5 DS who underwent decompression and fusion. Patients were divided into groups with dynamic instability and those without. Radiographs of the lumbar spine in neutral, flexion, and extension were used to determine degree of slip, DH, translational motion, angular motion, spondylotic changes, and lumbar lordosis. Magnetic resonance imaging (MRI) scans were reviewed to assess disc degeneration.
Results
Thirty-one percent of the patients met criteria for dynamic instability. Significant correlations (p < 0.05) were found between preserved DH and dynamic instability; increased spondylotic changes and decreased translational motion; as well as advanced MRI-based disc degeneration scores with decreased angular motion, respectively. Six radiographic parameters were utilized to create a predictive model for dynamic instability, and a receiver operating characteristic curve was able to validate the predictive model (area = 0.891, standard error = 0.034, p < 0.001).
Conclusion
In DS patients, preserved DH was significantly related to dynamic instability. This finding may represent a greater potential for slip progression over time in these patients. In contrast, disc degeneration on MRI, and spondylotic changes were inversely related to dynamic instability and may represent restabilization mechanisms that decrease the chance of future slip progression in DS.

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Radiologic Changes of Operated and Adjacent Segments after Anterior Cervical Microforaminotomy: Jang Ho Ahn, Moon Sun Park, Seong Min Kim, Seung Young Chung, Do Sung Lee, Ki Seok Park; Korean J Spine 2016;13(3):134-138. Published online September 30, 2016; DOI: https://doi.org/10.14245/kjs.2016.13.3.134

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Radiologic Changes of Operated and Adjacent Segments after Anterior Cervical Microforaminotomy

Korean J Spine. 2016;13(3):134-138. Published online September 30, 2016

DOI: https://doi.org/10.14245/kjs.2016.13.3.134

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Radiologic Changes of Operated and Adjacent Segments after Anterior Cervical Microforaminotomy

Korean J Spine. 2016;13(3):134-138. Published online September 30, 2016

DOI: https://doi.org/10.14245/kjs.2016.13.3.134

Objective

Anterior cervical microforaminotomy (ACMF) is a motion-preserving surgical procedure. The purpose of this study is to assess radiologic changes of operated and adjacent segments after ACMF.

Methods

We retrospectively reviewed 52 patients who underwent ACMF between 1998 and 2008. From X-ray film-based changes, disc height and sagittal range of motion (ROM) of operated and adjacent segments were compared at preoperative and last follow-up periods. Radiological degeneration of both segments was analyzed as well.

Results

The mean follow-up period was 48.2 months. There were 78 operated, 52 upper adjacent, and 38 lower adjacent segments. There were statistically significant differences in the ROM and disc height of operated segment between preoperative and last follow-up periods. However, there were no statistically significant differences in the ROM and disc height of adjacent segment between both periods. Radiological degenerative changes of operated segments were observed in 30%. That of adjacent segments was observed in 11 and 11% at upper and lower segments, respectively.

Conclusion

After mean 4-year follow-up periods, there were degenerative changes of operated segments. However, ACMF preserved motion and prevented degenerative changes of adjacent segments.

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Citations to this article as recorded by

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Jiahua Huang, Daniel Liu, Keshan Murugananthan, Saeed Kohan
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Neurologia medico-chirurgica.2020; 60(10): 492. CrossRef