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Diagnostics of instability at patients with degenerative disease of lumbar and sacral spine

Abstract

Objective. To analyze the literature data dedicated to diagnostics of vertebral segment instability at patients with lumbar osteochondrosis.

Material and methods. Search for Russian literature data was performed in central scientific library of First Medical State University n.a. I.M. Sechenov with the usage of internal search system. Search  for English literature data was conducted via Internet using Pubmed  and Medscape. The following key words were used during search:  vertebral osteochondrosis, degenerative disease, lumbar and sacral  spine, instability. Only full-text articles were analyzed.

Results. We found and analyzed 50 literature sources according to our criteria. The biomechanical base for vertebral instability  development are enlighted as well as hypotheses of such condition  development are discussed. The detailed results of modern trials  dedicated to estimation of clinical and instrumental examination of instability are presented.

Conclusion. The problem of lumbar instability because of vertebral osteochondrosis is widely studied. Mostly the term «instability» is  justified as clinical term. Nowadays there are no instrumental  method of examinations correlated in 100% with clinical manifestation of instability.

About the Authors

A. S. Nikitin
Московский государственный медико-стоматологический университет имени А.И. Евдокимова
Russian Federation


A. A. Grin’
Московский государственный медико-стоматологический университет имени А.И. Евдокимова ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»
Russian Federation


References

1. Сидоров Е.В. Клиника, диагностика и хирургическое лечение стеноза поясничного отдела позвоночного канала: дис. … канд. мед. наук. Москва, 2003. 147 с.

2. Хвисюк Н.И. Нестабильность поясничного отдела позвоночника: дис. … док. мед. наук. Харьков, 1977. 472 с.

3. Morgan F., King T. Primary instability of lumbar vertebrae as a common cause of low back pain. J Bone Joint Surg Br. 1957; 39(1): 6-22.

4. Jang S., Kong M., Hymanson H., Jin T. et al. Radiographic Parameters of Segmental Instability in Lumbar Spine Using Kinetic MRI. J Korean Neurosurg Soc 2009; 45: 24-31.

5. Panjabi M. The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. J Spinal Disord 1992; 5: 390—396.

6. Beazell1 J., Mullins1 M., Grindstaff T. Lumbar instability: an evolving and challenging concept. Journal of Manual and Manipulative Therapy 2010;18(1): 9-14.

7. Hasegawa K., Shimoda H., Kitahara K., Sasaki K., Homma T. What are the reliable radiological indicators of lumbar segmental instability? THE JOURNAL OF BONE AND JOINT SURGERY 2011; 93(5): 650-657.

8. Kirkaldy-Willis W., Farfan H. Instability of the lumbar spine. Clin Orthop Relat Res. 1982; 165: 110—123.

9. Lettin A. Diagnosis and treatment of lumbar instability. J Bone Joint Surg 1967; 3(49): 520-529.

10. O’Sullivan P. Lumbar segmental `instability’: clinical presentation and specific stabilizing exercise management. Manual Therapy 2000; 5(1): 2-12. 28. Paris S. Physical signs of instability. Spine (Phila Pa 1976) 1985; 10: 277-279.

11. Kasai Y., Morishita K., Kawakita E., Kondo T., Uchida A. A New Evaluation Method for Lumbar Spinal Instability: Passive Lumbar Extension Test. PHYS THER 2006; 86:1661- 1667.

12. Maigne J., Lapeyre E., Morvan G., Chatellier G. Pain immediately upon sitting down and relieved by standing up is often associated with radiologic lumbar instability or marked anterior loss of disc space. Spine (Phila Pa 1976) 2003; 28: 1327-1334.

13. Abbott J, McCane B, Herbison P, Moginie G, Chapple C, Hogarty T. Lumbar segmental instability: a criterion-related validity study of manual therapy assessment. BMC Musculoskelet Disord 2005; 6: 56.

14. Fritz J., Piva S., Childs J. Accuracy of the clinical examination to predict radiographic instability of the lumbar spine. Eur Spine J. 2005;14: 743-750.

15. Matsunaga S., Ijiri K., Hayashi K. Nonsurgically managed patients with degenerative spondylolisthesis: a 10- to 18-year follow-up study. J Neurosurg 2000; 93(2):194-198.

16. Simmonds A., Rampersaud R., Dvorak M. et al. Defining the inherent stability of degenerative spondylolisthesis: a systematic review. J Neurosurg Spine. 2015; 23:178—189.

17. Rampersaud Y., Fisher C., Yee A., Dvorak M. et al. Healthrelated quality of life following decompression compared to decompression and fusion for degenerative lumbar spondylolisthesis: a Canadian multicentre study. Can J Surg. 2014; 57: 126—133.

18. Hasegawa K., Kitahara K., Shimoda H., Ishii K. et al. Lumbar degenerative spondylolisthesis is not always unstable: clinicobiomechanical evidence. Spine (Phila Pa 1976). 2014; 39(26): 2127-2135.

19. Blumenthal C., Curran J., Benzel E. et al. Radiographic predictors of delayed instability following decompression without fusion for degenerative Grade I lumbar spondylolisthesis. J Neurosurg Spine. 2013; 18: 340—346.

20. Cinotti G., Postacchini F., Fassari F., Urso S. Predisposing factors in degenerative spondylolisthesis. A radiographic and CT study. Int Orthop. 1997; 21: 337—342.

21. Kleinstueck F., Fekete T., Mannion A., Grob D. To fuse or not to fuse in lumbar degenerative spondylolisthesis: do baseline symptoms help provide the answer? Eur Spine J. 2012; 21: 268—275.

22. Cabraja M., Mohamed E., Koeppen D., Kroppenstedt S. The analysis of segmental mobility with different lumbar radiographs in symptomatic patients with a spondylolisthesis. Eur Spine J. 2012; 21(2): 256-261.

23. Pieper C., Groetz S., Nadal J., Schild H., Niggemann P. Radiographic evaluation of ventral instability in lumbar spondylolisthesis: do we need extension radiographs in routine exams? // Eur Spine J. 2014; 23(1): 96-101.

24. Юмашев Г.С., Фурман А.Е. Остеохондрозы позвоночника. М.: Медицина, 1984. 376 с.

25. Schultz A., Warwick D., Berkson M., Nachemson A. Mechanical properties of human lumbar spine motion segments, part 1: Response inflexion, extension, lateral bending and torsion. Joint Biumechtmics Engineering 1979; 101: 46-52.

26. Iguchi T., Kanemura A., Kasahara K. et al. Lumbar instability and clinical symptoms: which is the more critical factor for symptoms: sagittal translation or segment angulation? J Spinal Disord Tech. 2004; 17: 284—290.

27. Ochia R., Inoue N., Renner S., Lorenz E., Lim T., Andersson G., An H. Three-dimensional in vivo measurement of lumbar spine segmental motion. Spine 2006; 31: 2073-2078.

28. Paris S. Physical signs of instability. Spine 1985; 10: 277-279.

29. Cakir B., Richter M., Kafer W., Wieser M., Puhl W., Schmidt R . Evaluation of Lumbar Spine Motion With Dynamic X-ray—A Reliability Analysis. MD SPINE 2006; 31: 1258-1264.

30. Barr J. Editorial back pain. J Bone Joint Surg 1950; 32B: 461—569.

31. Pfirrmann C., Metzdorf A., Zanetti M., Hodler J., Boos N. Magnetic resonance grade of lumbar intervertebral disc degeneration. Spine 2001; 26: 1873—1878.

32. Ibarz1 E., Mбs Y., Mateo J., Lobo-Escolar A. et al. Instability of the lumbar spine due to disc degeneration. A finite element simulation. Advances in Bioscience and Biotechnology 2013; 4: 548-556.

33. Fujiwara A., Lim T., An H., Tanaka N. et al. The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine 2000; 25: 3036-3044.

34. Lattig F., Fekete T., Grob D., Kleinstьck F. et al. Lumbar facet joint effusion in MRI: a sign of instability in degenerative spondylolisthesis? Eur Spine J. 2012; 21: 276—281.

35. Caterini R, Mancini F, Bisicchia S, Maglione P, Farsetti P. The correlation between exaggerated fluid in lumbar facet joints and degenerative spondylolisthesis: prospective study of 52 patients. J Orthopaedics and Traumatology 2011; 12(2): 87—91.

36. Rihn J., Lee J., Khan M., Ulibarri J. et al. Does lumbar facet fluid detected on magnetic resonance imaging correlate with radiographic instability in patients with degenerative lumbar disease? Spine 2007; Vol.32(14): 1555- 1560.

37. Oishi Y., Murase M., Hayashi Y., Ogawa T., Hamawaki J. Smaller facet effusion in association with restabilization at the time of operation in Japanese patients with lumbar degenerative spondylolisthesis. J Neurosurg Spine 2010; 12: 88—95.

38. Tamai K., Kato M., Konishi S., Matsumura A. et al. Facet Effusion without Radiographic Instability Has No Effect on the Outcome of Minimally Invasive Decompression Surgery. Global Spine J. 2017; 7(1): 21—27.

39. Sheng-yun L., Letu S., Jian C. et al. Comparison of Modic changes in the lumbar and cervical spine, in 3167 Patients with and without spinal pain. PLOS ONE. 2014; 9(12): e114993.

40. Weishaupt D., Zanetti M., Hodler J., Boos N. MR imaging of the lumbar spine: prevalence of intervertebral disk extrusion and sequestration, nerve root compression, end plate abnormalities, and osteoarthritis of the facet joints in asymptomatic volunteers. Radiology 1998; 209: 661—666.

41. Toyone T., Takahashi K., Kitahara H. et al. Vertebral bonemarrow changes in degenerative lumbar disc disease an MRI study of 74 patients with low back pain. J BoneJoint Surg. 1994; 76: 757-764.

42. Brдm J., Zanetti M., Min K., Hodler J. MR abnormalities of the intervertebral disks and adjacent bone marrow as predictors of segmental instability of the lumbar spine. Acta Radiol. 1998; 39(1): 18-23.

43. Sшrlie A., Moholdt V., Kvistad et al. Modic type I changes and recovery of back pain after lumbar microdiscectomy. Eur Spine J. 2012; 21: 2252—2258.

44. Peng C., Zhe C., Yuehuan Z. et al. Comparison of simple discectomy and instrumented posterior lumbar interbody fusion for treatment of lumbar disc herniation combined with Modic endplate changes. Chinese Medical Journal. 2014; 127(15): 2789-2794.

45. Yang Y., Cao P., Pan Y. et al. Selection of surgical methods for lumbar disc herniation with degenerative endplates changes. Zhonghua Yi Xue Za Zhi. 2009; 89(27): 1902-1926.

46. Chin K., Tomlinson D., Auerbach J. et al. Success of lumbar microdiscectomy in patients with modic changes and lowback pain: a prospective pilot study. J Spinal Disord Tech. 2008; 21(2): 139-144.

47. Ohtori S., Yamashita M., Yamauchi K. et al. Low back pain after lumbar discectomy in patients showing endplate modic type 1 change. Spine (Phila Pa 1976). 2010; 35(13): 596-600.

48. Buttermann G., Heithoff K., Ogilvie J. et al. Vertebral body MRI related to lumbar fusion results. Eur Spine J. 1997; 6: 115-120.

49. Kwon Y., Chin D., Jin B. et al. Long term efficacy of posterior lumbar interbody fusion with standard cages alone in lumbar disc diseases combined with modic changes. J Korean Neurosurg Soc. 2009; 46: 322-327.

50. Ghodsi S., Rouhani R., Abdollahzade S. et al. Frequency of vertebral endplate modic changes in patients with unstable lumbar spine and its effect on surgical outcome. Asian Spine J. 2015; 9(5): 737-740.


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Nikitin A.S., Grin’ A.A. Diagnostics of instability at patients with degenerative disease of lumbar and sacral spine. Russian journal of neurosurgery. 2017;(3):102-111. (In Russ.)

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