지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
- 수록면
- 507 - 512 (6page)
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Study Design: Retrospective evaluation.Purpose: To determine the prevalence of mid-range dynamic instability in patients with degenerative spondylolisthesis (DS) and to evaluate the clinical implication of mid-range instability (MI).Overview of Literature: Instability is identified by measuring vertebral body anterior–posterior translation on static end-range flexion and extension lateral radiographs. Mid-range kinematics could evince occult dynamic instability in which motion is not appreciated at the terminal-range of motion.Methods: In this study, 30 patients with DS with checked standing dynamic radiographs of the lumbar spine in Gwangmyeong Sungae Orthopedic Clinic were recruited. Standing lateral radiographs were evaluated in extension, 45° of flexion (mid-range) and 90° of flexion (terminal-range) of the lumbar spine. Instability was defined as sagittal translation greater than 3 mm from the extension position. Patients were divided into three groups: a control group, an MI group, and a terminal-range instability (TI) group. Radiographic outcome (stenosis grade) and clinical outcome were compared between the three groups.Results: The average sagittal translation of the lumbar spine was 5.2 mm in extension, 6.6 mm in mid-range, and 7.2 mm in endrange. MI was observed in eight patients (26.2%) and TI was seen in 12 patients (40%). Of eight patients with MI, three patients did not have instability at terminal-range (occult patients) and five patients had instability at terminal-range (typical patients). Body weight and body mass index (BMI) was significantly higher in the MI group as compared to the control group. BMI was positively correlated with slippage to mid-range. There was no significant difference in stenosis grade, Visual Analog Scale, and Oswestry Disability Index. In the TI group, there was no significant difference in radiographic clinical parameters as compared to the control group.Conclusions: MI was demonstrated in 25% of DS patients. Mid-range motion was increased with BMI. Mid-range lateral radiography can reveal occult instability in patients with DS, particularly in obese patients.
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참고문헌 (19)
참고문헌 신청
Resnick DK / 2014 / Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine : part 9 : lumbar fusion for stenosis with spondylolisthesis / J Neurosurg Spine 21:54~61
Weinstein JN / 2009 / Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis : four-year results in the Spine Patient Outcomes Research Trial(SPORT)randomized and observational cohorts / J Bone Joint Surg Am 91:1295~1304
Ghogawala Z / 2016 / Laminectomy plus fusion versus laminectomy alone for lumbar spondylolisthesis / N Engl J Med 374:1424~1434
Herkowitz HN / 1991 / Degenerative lumbar spondylolisthesis with spinal stenosis : a prospective study comparing decompression with decompression and intertransverse process arthrodesis / J Bone Joint Surg Am 73:802~808
Blumenthal C / 2013 / Radiographic predictors of delayed instability following decompression without fusion for degenerative grade I lumbar spondylolisthesis / J Neurosurg Spine 18:340~346
Weinstein JN / 2009 / Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis : four-year results in the Spine Patient Outcomes Research Trial(SPORT)randomized and observational cohorts / J Bone Joint Surg Am 91:1295~1304
Ghogawala Z / 2016 / Laminectomy plus fusion versus laminectomy alone for lumbar spondylolisthesis / N Engl J Med 374:1424~1434
Herkowitz HN / 1991 / Degenerative lumbar spondylolisthesis with spinal stenosis : a prospective study comparing decompression with decompression and intertransverse process arthrodesis / J Bone Joint Surg Am 73:802~808
Blumenthal C / 2013 / Radiographic predictors of delayed instability following decompression without fusion for degenerative grade I lumbar spondylolisthesis / J Neurosurg Spine 18:340~346
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