KINEMATICS OF LUMBAR SEGMENTS ADJACENT TO THE RIGID INSTRUMENTED POSTEROLATERAL SPINAL FUSION
https://doi.org/10.14531/ss2014.3.45-53
Abstract
Objective: To study the range of motion of segments proximal to the fused area and its relationship with some parameters of vertical posture in patients with lumbar degenerative disc disease and degenerative lumbar spondylolisthesis at stages of the surgical treatment.
Material and Methods. Protocols of clinical and radiological examination of 52 male patients with instability of the low lumbar segments combined with spondyloarthrosis and/or spinal stenosis, and/or herniated lumbar intervertebral discs were analyzed.
Results. Preoperative examination detected a flattening of the lumbar lordosis and verticalization of the sacrum combined with a significant decrease in excursions of the lumbar spine. Improvement in the sagittal contour of the spine achieved after surgery did not improved significantly the lumbar segments kinematics.
Conclusion. The altered lumbar segmental mobility may be caused by incorrect movement patterns due to unrepaired myotonic reactions and inadequate spinal motion strategies.
About the Authors
Vladimir Alexandrovich Radchenko
Sytenko Institute of Spine and Joint Pathology, Kharkov, Ukrainе
Russian Federation
Russian Federation
Vera Anatolyevna Kolesnichenko
Sytenko Institute of Spine and Joint Pathology, Kharkov, Ukrainе
Russian Federation
Russian Federation
Ma Cong
Sytenko Institute of Spine and Joint Pathology, Kharkov, Ukrainе
Russian Federation
Russian Federation
Artyom Gennadyevich Skidanov
Sytenko Institute of Spine and Joint Pathology, Kharkov, Ukrainе
Russian Federation
Russian Federation
Konstantin Nikolayevich Litvinenko
Sytenko Institute of Spine and Joint Pathology, Kharkov, Ukrainе
Russian Federation
Russian Federation
References
1. Auerbach JD, Jones KJ, Milby AH, et al. Segmental contribution toward total lumbar range of motion in disc replacement and fusions: a comparison of operative and adjacent levels. Spine. 2009;34:2510-2517. doi: 10.1097/BRS.0b013e3181af2622.
2. Auerbach JD, Wills BP, McIntosh TC, et al. Evaluation of spinal kinematics following lumbar total disc replacement and circumferential fusion using in vivo fluoroscopy. Spine. 2007;32:527-536.
3. Bastian L, Lange U, Knop C, еt al. Evaluation of the mobility of adjacent segments after posterior thoracolumbar fixation: a biomechanical study. Eur Spine J. 2001;10:295-300.
4. Brumagne S, Cordo P, Lysens R, et al. The role of paraspinal muscle spindles in lumbosacral position sense in individuals with and without low back pain. Spine. 2000; 25:989-994.
5. Cakir B, Carazzo C, Schmidt R, et al. Adjacent segment mobility after rigid and semirigid instrumentation of the lumbar spine. Spine. 2009;34:1287-1291. doi: 10.1097/BRS.0b013e3181a136ab.
6. Chen WJ, Lai PL, Chen LH. Adjacent instability after instrumented lumbar fusion. Chang Gung Med J. 2003;26:792-798.
7. Chen WJ, Lai PL, Tai CL, et al. The effect of sagittal alignment on adjacent joint mobility after lumbar instrumentation - a biomechanical study of lumbar vertebrae in a porcine model. Clin Biomech (Bristol, Avon). 2004;19:763-768.
8. Cheng BC, Gordon J, Cheng J, еt аl. Immediate biomechanical effects of lumbar posterior dynamic stabilization above a circumferential fusion. Spine. 2007;32:2551-2557.
9. Chow DH, Luk KD, Evans JH, et al. Effects of short anterior lumbar interbody fusion on biomechanics of neighboring unfused segments. Spine. 1996;21:549-555.
10. Cobb JR. Outline for the study of scoliosis. Instr Course Lectures. The American Academy of Orthopaedic Surgeons. 1948;5:261-275.
11. Cosette JW, Farfan HF, Robertson GH, et al. The instantaneous center of rotation of the third lumbar vertebral joint. J Biomech. 1971;4:149-153.
12. Dekutoski MB, Schendel MJ, Ogilvie JW, et al. Comparison of in vivo and in vitro adjacent segment motion after lumbar fusion. Spine. 1994;19:1745-1751.
13. Dolan P, Earley M, Adams MA. Bending and compressive stresses acting on the lumbar spine during lifting activities. J Biomech. 1994;27:1237-1248.
14. Duval-Beaupere G, Schmidt C, Cosson PH. A barycentremetric study of the sagittal shape of the spine and pelvis: the conditions required for an economic position. Ann Biomed Eng. 1992;20:451-462.
15. Ensink FB, Saur PM, Frese K, et al. Lumbar range of motion: influence of time of day and individual factors on measurements. Spine. 1996;21:1339-1343.
16. Esses SI, Doherty BJ, Crawford MJ, et al. Kinematic evaluation of lumbar fusion techniques. Spine. 1996;21:676-684.
17. Glassman SD, Berven S, Bridwell K, et al. Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine. 2005;30:682-688.
18. Glassman SD, Bridwell K, Dimar JR, et al. The impact of positive sagittal balance in adult spinal deformity. Spine. 2005;30:2024-2029.
19. Goldstein JA, Macenski MJ, Griffith SL, et al. Lumbar sagittal alignment after fusion with a threaded interbody cage. Spine. 2001;26:1137-1142.
20. Harada M, Abumi K, Ito M, et al. Cineradiographic motion analysis of normal lumbar spine during forward and backward flexion. Spine. 2000;25:1932-1937.
21. Hodges PW, Moseley GL. Pain and motor control of the lumbopelvic region: effect and possible mechanisms. J Electromyogr Kinesiol. 2003;13:361-370.
22. Kim MK, Lee SH, Kim ES, et al. The impact of sagittal balance on clinical results after posterior interbody fusion for patients with degenerative spondylolisthesis: a pilot study. BMC Musculoskelet Disord. 2011;12:69. doi: 10.1186/1471-2474-12-69.
23. Kim HJ, Moon SH, Chun HJ, et al. Comparison of mechanical motion profiles following instrumented fusion and non-instrumented fusion at the L4-5 segment. Clin Invest Med. 2009;32:E64-E69.
24. Lazennec JY, Ramare S, Arafati N, et al. Sagittal alignment in lumbosacral fusion: relations between radiological parameters and pain. Eur Spine J. 2000;9:47-55.
25. Lee CK, Langrana NA. Lumbosacral spinal fusion. A biomechanical study. Spine. 1984;9:574-581.
26. Le Huec JC, Charosky S, Barrey C, et al. Sagittal imbalance cascade for simple degenerative spine and consequences: algorithm of decision for appropriate treatment. Eur Spine J. 2011;20 Suppl 5:699-703. doi: 10.1007/s00586-011-1938-8.
27. Mac-Thiong JM, Transfeldt EE, Mehbod AA, et al. Can c7 plumbline and gravity line predict health related quality of life in adult scoliosis? Spine. 2009;34:E519-E527. doi: 10.1097/BRS.0b013e3181a9c7ad.
28. Morishita Y, Ohta H, Naito M, et al. Kinematic evaluation of the adjacent segments after lumbar instrumented surgery: a comparison between rigid fusion and dynamic non-fusion stabilization. Eur Spine J. 2011;20:1480-1485. doi: 10.1007/s00586-011-1701-1.
29. Nagata H, Schendel MJ, Transfeldt EE, et al. The effects of immobilization of long segments of the spine on the adjacent and distal facet force and lumbosacral motion. Spine. 1993;18:2471-2479.
30. Nelson-Wong E, Alex B, Csepe D, et al. Altered muscle recruitment during extension from trunk flexion in low back pain developers. Clin Biomech (Bristol, Avon). 2012;27:994-998. doi: 10.1016/j.clinbiomech.2012.07.007.
31. Okuda S, Iwasaki M, Miyauchi A, et al. Risk factors for adjacent segment degeneration after PLIF. Spine. 2004;29:1535-1540.
32. Panjabi MM. A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction. Eur Spine J. 2006;15:668-676.
33. Panjabi M, Malcolmson G, Teng E, et al. Hybrid testing of lumbar CHARITE discs versus fusions. Spine. 2007;32:959-966.
34. Panjabi M, Yamamoto I, Oxland T, et al. How does posture affect the coupling in the lumbar spine? Spine. 1989;14:1002-1011.
35. Pearcy M, Portek J, Shepherd J. Three-dimensional x-ray analysis of normal movement in the normal spine. Spine. 1984;9:294-297.
36. Pearcy MJ. Stereo radiography of lumbar spine motion. Acta Orthop Scand Suppl. 1985;212:1-45.
37. Pearcy MJ, Tibrewal SB. Axial rotation and lateral bending in the normal lumbar spine measured by three-dimensional radiography. Spine. 1984;9:582-587.
38. Pedersen J, Ljubisavljevic M, Bergenheim M, et al. Alterations in information transmission in ensembles of primary muscle spindle afferents after muscle fatigue in heteronymous muscle. Neuroscience. 1998;84:953-959.
39. Phillips S, Mercer S, Bogduk N. Anatomy and biomechanics of quadratus lumborum. Proc Inst Mech Eng H. 2008;222:151-159.
40. Rao RD, David KS, Wang M. Biomechanical changes at adjacent segments following anterior lumbar interbody fusion using tapered cages. Spine. 2005;30:2772-2776.
41. Roussouly P, Pinheiro-Franco JL. Sagittal parameters of the spine: biomechanical approach. Eur Spine J. 2011;20 Suppl 5:578-585. doi: 10.1007/s00586-011-1924-1.
42. Shono Y, Kaneda K, Abumi K, et al. Stability of posterior spinal instrumentation and its effects on adjacent motion segments in the lumbosacral spine. Spine. 1998;23:1550-1558.
43. Troke M, Moore AP, Maillardet FJ, et al. A new, comprehensive normative database of lumbar spine ranges of motion. Clin Rehabil. 2001;15:371-379.
44. Umehara S, Zindrick MR, Patwardhan AG, et al. The biomechanical effect of postoperative hypolordosis in instrumented lumbar fusion on instrumented and adjacent spinal segments. Spine. 2000;25:1617-1624.
45. White AA, Panjabi MM. Clinical Biomechanics of the Spine. 2nd ed. Philadelphia PA: J.B. Lippincott Company, 1990. 772 p.
46. Xia Q, Wang S, Passias PG, et al. In vivo range of motion of the lumbar spinous processes. Eur Spine J. 2009;18:1355-1362. doi: 10.1007/s00586-009-1068-8.
47. Yang SW, Langrana NA, Lee CK. Biomechanics of lumbosacral spinal fusion in combined compression-torsion loads. Spine. 1986;11:937-941.
48. Zhao K, Yang C, Zhao C, et al. Assessment of non-invasive intervertebral motion measurements in the lumbar spine. J Biomech. 2005;38:1943-1946.
Review
For citations:
Radchenko V.A., Kolesnichenko V.A., Cong M., Skidanov A.G., Litvinenko K.N. KINEMATICS OF LUMBAR SEGMENTS ADJACENT TO THE RIGID INSTRUMENTED POSTEROLATERAL SPINAL FUSION. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2014;(3):45-53. (In Russ.) https://doi.org/10.14531/ss2014.3.45-53
Email this article 