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学科主题临床医学
How Does Lumbar Degenerative Disc Disease Affect the Disc Deformation at the Cephalic Levels In Vivo?
Wang, Shaobai1,2; Xia, Qun1,3; Passias, Peter1; Li, Weishi1,4; Wood, Kirkham1; Li, Guoan1
关键词adjacent segment degenerative disc disease imaging technique intervertebral disc deformation in vivo lumbar spine MRI
刊名SPINE
2011-04-01
DOI10.1097/BRS.0b013e3181f79e93
36期:9页:E574-E581
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Clinical Neurology ; Orthopedics
研究领域[WOS]Neurosciences & Neurology ; Orthopedics
关键词[WOS]ADJACENT SEGMENT DEGENERATION ; LOW-BACK-PAIN ; FINITE-ELEMENT-ANALYSIS ; INTERVERTEBRAL DISC ; INTERBODY FUSION ; FOLLOW-UP ; POSTEROLATERAL FUSION ; INTRADISCAL PRESSURE ; LUMBOSACRAL FUSION ; SPINAL-FUSION
英文摘要

Study Design. Case-control study.

Objective. To evaluate the effect of lumbar degenerative disc disease (DDD) on the disc deformation at the adjacent level and at the level one above the adjacent level during end ranges of lumbar motion.

Summary of Background Data. It has been reported that in patients with DDD, the intervertebral discs adjacent to the diseased levels have a greater tendency to degenerate. Although altered biomechanics have been suggested to be the causative factors, few data have been reported on the deformation characteristics of the adjacent discs in patients with DDD.

Methods. Ten symptomatic patients with discogenic low back pain between L4 and S1 and with healthy discs at the cephalic segments were involved. Eight healthy subjects recruited in our previous studies were used as a reference comparison. The in vivo kinematics of L3-L4 (the cephalic adjacent level to the degenerated discs) and L2-L3 (the level one above the adjacent level) lumbar discs of both groups were obtained using a combined magnetic resonance imaging and dual fluoroscopic imaging technique at functional postures. Deformation characteristics, in terms of areas of minimal deformation (defined as less than 5%), deformations at the center of the discs, and maximum tensile and shear deformations, were compared between the two groups at the two disc levels.

Results. In the patients with DDD, there were significantly smaller areas of minimal disc deformation at L3-L4 and L2-L3 than the healthy subjects (18% compared with 45% of the total disc area, on average). Both L2-L3 and L3-L4 discs underwent larger tensile and shear deformations in all postures than the healthy subjects. The maximum tensile deformations were higher by up to 23% (of the local disc height in standing) and the maximum shear deformations were higher by approximately 25% to 40% (of the local disc height in standing) compared with those of the healthy subjects.

Conclusion. Both the discs of the adjacent level and the level one above experienced higher tensile and shear deformations during end ranges of lumbar motion in the patients with DDD before surgical treatments when compared with the healthy subjects. The larger disc deformations at the cephalic segments were otherwise not detectable using conventional magnetic resonance imaging techniques. Future studies should investigate the effect of surgical treatments, such as fusion or disc replacement, on the biomechanics of the adjacent segments during end ranges of lumbar motion.

语种英语
WOS记录号WOS:000289405700002
项目编号R21AR057989
资助机构ECOR, MGH ; NIH
引用统计
被引频次:11[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/61471
专题北京大学第三临床医学院_骨科
作者单位1.MA Inst Technol, Dept Mech Engn, Cambridge, MA USA
2.Tianjin Hosp, Dept Spine Surg, Tianjin, Peoples R China
3.Harvard Univ, Sch Med, MA Gen Hosp, Bioengn Lab,Dept Orthopaed Surg, Boston, MA 02114 USA
4.Peking Univ, Hosp 3, Dept Orthopaed, Beijing 100871, Peoples R China
推荐引用方式
GB/T 7714
Wang, Shaobai,Xia, Qun,Passias, Peter,et al. How Does Lumbar Degenerative Disc Disease Affect the Disc Deformation at the Cephalic Levels In Vivo?[J]. SPINE,2011,36(9):E574-E581.
APA Wang, Shaobai,Xia, Qun,Passias, Peter,Li, Weishi,Wood, Kirkham,&Li, Guoan.(2011).How Does Lumbar Degenerative Disc Disease Affect the Disc Deformation at the Cephalic Levels In Vivo?.SPINE,36(9),E574-E581.
MLA Wang, Shaobai,et al."How Does Lumbar Degenerative Disc Disease Affect the Disc Deformation at the Cephalic Levels In Vivo?".SPINE 36.9(2011):E574-E581.
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