Disc height loss after anterior cervical microdiscectomy with titanium intervertebral cage fusion

2003 ◽  
Vol 145 (7) ◽  
pp. 565-570 ◽  
Author(s):  
K. T�reyen
Keyword(s):  
Disc Height ◽  
Height Loss ◽  
Intervertebral Cage

DYNAMIC RESPONSES OF INTERVERTEBRAL DISC DURING STATIC CREEP AND DYNAMIC CYCLIC LOADING: A PARAMETRIC POROELASTIC FINITE ELEMENT ANALYSIS

2013 ◽  
Vol 25 (01) ◽  
pp. 1350013 ◽  
Author(s):  
Mohammad Nikkhoo ◽  
Mohammad Haghpanahi ◽  
Mohamad Parnianpour ◽  
Jaw-Lin Wang
Keyword(s):  
Finite Element ◽  
Elastic Modulus ◽  
Intervertebral Disc ◽  
Pore Pressure ◽  
Void Ratio ◽  
Disc Height ◽  
Poisson's Ratio ◽  
Height Loss ◽  
Loading Frequency ◽  
Loading Conditions

Low back pain is a common reason for activity limitation in people younger than 45 years old, and was proved to be associated with heavy physical works, repetitive lifting, impact, stationary work postures and vibrations. The study of load transferring and the loading condition encountered in spinal column can be simulated by finite element models. The intervertebral disc is a structure composed of a porous material. Many physical models were developed to simulate this phenomenon. The confounding effects of poroelastic properties and loading conditions on disc mechanical responses are, nevertheless, not cleared yet. The objective of this study was to develop an axisymmetric poroelastic finite element model of intervertebral disc and use it to investigate the confounding effect of material properties and loading conditions on the disc deformation and pore pressure. An axisymmetric poroelastic model of human lumbar L4–L5 motion segment was developed. The model was validated by comparing the height loss and intradiscal pressure of the L4–L5 intervertebral disc with in vitro cadaveric studies. The effect of permeability, void ratio, elastic modulus, and Poisson's ratio on disc height and pore pressure was investigated for the following three loading conditions: (1) 1334 N creep loading, (2) peak-to-peak, 1000-to-1600 N, 1 Hz cyclic loading, and (3) same loading magnitude, but at 5 Hz loading frequency. The disc height loss and pore pressure of the three loading conditions were analyzed. The predictions of the disc height loss and intradiscal pressure of the current FE model are well comparable with the results of in vitro cadaveric studies. After model validation, the parametric study of disc poroelastic properties on the disc mechanical responses shows that the increase of permeability and void ratio increases the disc height loss and decreases the pore pressure, and these effects are sensitive to external loading frequency. Higher elastic modulus reduces the disc deformation and the pore pressure, but this reduction is not sensitive to the loading frequency. The effect of Poisson's ratio on disc height loss and pore pressure is negligible. In conclusion, the hydraulic permeability describes the fluid flow capability within tissue matrix which has a higher sensitivity on the saturation time for disc deformation and pore pressure. Void ratio directly affects the amount of mobile water within disc and changes time-dependent response of disc. Increase in loading frequency reduces time for fluid inflow and outflow, which fades out the role of permeability and void ratio. Values of elastic modulus and Poisson's ratio, which demonstrates stiffness and bulging capacity, respectively, do not affect the overall dynamic response of disc.

scholarly journals Comparative Study between Full-Endoscopic Discectomy and Microendoscopic Discectomy for the Treatment of Lumbar Disc Herniation

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 710
Author(s):  
Muneyoshi Fujita ◽  
Tomoaki Kitagawa ◽  
Masahiro Hirahata ◽  
Takahiro Inui ◽  
Hirotaka Kawano ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Disc Height ◽  
Leg Pain ◽  
Height Loss ◽  
Common Disease ◽  
Low Back ◽  
Endoscopic Discectomy ◽  
Microendoscopic Discectomy

Background and objectives: Lumbar disc herniation (LDH) is a common disease in the meridian of life. Although surgical discectomy is commonly used to treat LDH, there are several different strategies. We compared the outcomes of uniportal full-endoscopic discectomy (FED) with those of microendoscopic discectomy (MED) in treating LDH. Materials and Methods: FED was performed using a 4.1-mm working channel endoscope, and MED was performed using a 16-mm diameter tubular retractor and endoscope. Data of patients with LDH treated with FED (n = 39) or MED (n = 27) by the single surgeon were retrospectively reviewed. Patient background information and operative data were collected. Pre- and postoperative low back and leg pain were evaluated using the numerical rating scale (NRS) score. Pre- and postoperative disc height index (DHI) values were calculated from plain radiographs, and the disc height loss was evaluated using the ratio (DHI ratio); Results: The median (interquartile range (IQR) Q25–75) operation times for FED and MED were 42 (33–61) and 43 (33–50) minutes, respectively. The median (IQR Q25–75) pre- and postoperative NRS scores for low back pain were 5 (2–7) and 1 (0–4), respectively, for FED and 6 (3–8) and 1 (0–2), respectively, for MED. The median (IQR Q25–75) pre- and postoperative NRS scores for leg pain were 7 (5–8) and 0 (0–2), respectively, for FED and 6 (5–8) and 0 (0–2), respectively, for MED. These data were not different between the FED and MED groups. The median (IQR Q25–75) DHI ratios of FED and MED were 0.94 (0.89–1.03) and 0.90 (0.79–0.95), respectively. The DHI ratio was significantly higher (p < 0.05) in the FED group than in the MED group, and there was less blood loss; Conclusions: The pain-relieving effect of FED in treating LDH was almost identical to that of MED. However, FED was superior to MED in preventing disc height loss, which is one of the indicators of postoperative disc degeneration.

scholarly journals The impact of age, sex, disc height loss and T1 slope on the upper and lower cervical lordosis: a large-scale radiologic study

2021 ◽  
Author(s):  
Youping Tao ◽  
Fabio Galbusera ◽  
Frank Niemeyer ◽  
René Jonas ◽  
Dino Samartzis ◽  
...  
Keyword(s):  
Large Scale ◽  
Disc Height ◽  
Relative Influence ◽  
Height Loss ◽  
Cervical Lordosis ◽  
Regression Analyses ◽  
Disc Space ◽  
T1 Slope ◽  
Radiologic Study ◽  
The Impact

Abstract Purpose To clarify the relative influence of age, sex, disc height loss and T1 slope on upper (Occiput-C2) and lower cervical lordosis (C2–C7). Methods Standing lateral cervical radiographs of 865 adult subjects were evaluated. The presence and severity of disc height loss from C2/C3 to C6/C7 (a total of 4325 discs) were assessed using a validated grading system. The total disc height loss score for each subject was calculated as the sum of the score of each disc space. Sagittal radiographic parameters included: occipital slope, occiput-C2 (Oc-C2) lordosis, C2–C7 lordosis and T1 slope. Multivariable regression analyses were performed to examine the relative influence of the multiple factors on upper and lower cervical lordosis. Results This study included 360 males and 505 females, with a mean age of 40.2 ± 16.0 years (range, 20–95 years). Linear multivariate regression analyses showed that greater age, male sex, greater T1 slope were each found to be significantly and independently associated with greater C2–C7 lordosis, whereas total disc height loss score was negatively associated with C2–C7 lordosis. T1 slope had the most independent influence on C2–C7 lordosis among these factors. Age, sex and disc height loss were not independently associated with Oc-C2 lordosis. Conclusions Results from our large-scale radiologic analysis may enhance the understanding of the factors that affect cervical lordosis, indicating that age, sex, disc height loss and T1 slope were each independently associated with C2–C7 lordosis. However, age, sex and disc height loss were not independently associated with upper cervical lordosis.

Does index level sagittal alignment determine adjacent level disc height loss?

2019 ◽  
Vol 31 (4) ◽  
pp. 579-586 ◽  
Author(s):  
Ryan Snowden ◽  
Justin Miller ◽  
Tome Saidon ◽  
Joseph D. Smucker ◽  
K. Daniel Riew ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Sagittal Alignment ◽  
Disc Height ◽  
Cervical Disc ◽  
Height Loss ◽  
Adjacent Segment ◽  
Distance Ratio ◽  
Cervical Disc Prosthesis ◽  
Index Level

OBJECTIVEThe authors sought to compare the effect of index level sagittal alignment on cephalad radiographic adjacent segment pathology (RASP) in patients undergoing cervical total disc arthroplasty (TDA) or anterior cervical discectomy and fusion (ACDF).METHODSThis was a retrospective study of prospectively collected radiographic data from 79 patients who underwent TDA or ACDF and were enrolled and followed prospectively at two centers in a multicenter FDA investigational device exemption trial of the Bryan cervical disc prosthesis used for arthroplasty. Neutral lateral radiographs were obtained pre- and postoperatively and at 1, 2, 4, and up to 7 years following surgery. The index level Cobb angle was measured both pre- and postoperatively. Cephalad disc degeneration was determined by a previously described measurement of the disc height/anteroposterior (AP) distance ratio.RESULTSSixty-eight patients (n = 33 ACDF; n = 35 TDA) had complete radiographs and were included for analysis. Preoperatively, there was no difference in the index level Cobb angle between the ACDF and TDA patients. Postoperatively, the ACDF patients had a larger segment lordosis compared to the TDA patients (p = 0.002). Patients who had a postoperative kyphotic Cobb angle were more likely to have undergone TDA (p = 0.01). A significant decrease in the disc height/AP distance ratio occurred over time (p = 0.035), by an average of 0.01818 at 84 months. However, this decrease was not influenced by preoperative alignment, postoperative alignment, or type of surgery.CONCLUSIONSIn this cohort of patients undergoing TDA and ACDF, the authors found that preoperative and postoperative sagittal alignment have no effect on RASP at follow-up of at least 7 years. They identified time as the only significant factor affecting RASP.

Clinical application of a novel assessment for lumbosacral stability

2010 ◽  
Vol 13 (2) ◽  
pp. 276-282 ◽  
Author(s):  
Kazuo Ohmori
Keyword(s):  
Degenerative Spondylolisthesis ◽  
Transverse Process ◽  
Disc Height ◽  
Major Influence ◽  
Height Loss ◽  
Z Score ◽  
Lumbosacral Junction ◽  
Disc Space Narrowing ◽  
Disc Space ◽  
Age Related

Object To evaluate the grade of lumbosacral stability, shape analysis was conducted on plain radiographs of the lumbar spine. Methods One hundred twenty-six patients were classified into 2 groups: those with a single-segment disc space narrowing at L5–S1 or at L4–5. Stability was evaluated using the discriminant function (z score) derived from the analysis of radiographic parameters—that is, relative thickness of transverse process of L-5 and the sacral table angle. Results In patients with a space narrowing at L5–S1, the author observed a significantly slender L-5 transverse process and acute obliquity of the sacral endplate; accordingly, the z score was negative. In patients with a broad transverse process and a positive z score, the segment associated with disc height loss was L4–5. Thus, a close correlation was found between the site of the disc height loss and the bony characteristics of L-5 and S-1. Furthermore, it could be expected with a high degree reliability that when young adult patients had a z score less than −2 or −3, their L-5 vertebra would develop degenerative spondylolisthesis after middle age and the L5–S1 segment could be saved from age-related alterations as long as the z score was greater than 2.5. The constitutional characteristics of the lumbosacral junction may exert a major influence on the site of disc degeneration. Conclusions Stability at the lumbosacral junction was thought to be quantitatively represented by the z score, with z being designated the lumbosacral stability score.

scholarly journals Lumbar Schmorl’s Nodes and Their Correlation with Spine Configuration and Degeneration

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Janan Abbas ◽  
Kamal Hamoud ◽  
Natan Peled ◽  
Israel Hershkovitz
Keyword(s):  
Body Length ◽  
Vertebral Body ◽  
Medical Center ◽  
Smoking Habit ◽  
Disc Height ◽  
Height Loss ◽  
Lumbar Region ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Vacuum Phenomenon ◽  
Schmorl’S Nodes

The aim of this study was to reveal whether demographic aspect, vertebral morphometry, and spine degeneration are associated with lumbar Schmorl’s nodes (SNs). A retrospective cross-sectional study was performed using data from the Department of Radiology (Carmel, Medical Center, Israel) for 180 individuals: age range between 40 and 99 years; 90 males and 90 females. All participants had undergone high-resolution CT scans for abdominal diagnostic purposes in the same supine position prior to our study, which enabled the processing of the scans in all planes and allowed a 3D reconstruction of the lower lumbar region. Eighty individuals (44.4%) had at least one SN along the lumbar spine, particularly at L3-4 level (30%). Vertebral body length (L1 to L3) and width (L1 and L4) were significantly greater in the SNs group compared to non-SNs group. On contrast, disc height (L3-4 and L4-5) was significantly lesser in SNs group than non-SNs group. SNs was significantly associated with smoking (X2= 4.436, P=0.02) and degenerative lumbar spinal stenosis (X2= 5.197, P=0.038). Moreover, the prevalence of SN was significantly greater in individuals with vacuum phenomenon and osteophytes formation (L1-2 to L4-5 levels). This study indicates that vacuum phenomenon on L3-4 (OR: 4.7, P=0.034), smoking habit (OR: 3.2, P=0.003), disc height loss of L4-5 (OR: 0.798, P=0.008), vertebral body length of L1 (OR: 1.37, P<0.001), and age (OR: 1.05, P=0.002) increase the probability of developing lumbar SNs.

Intervertebral disc height loss demonstrates the threshold of major pathological changes during degeneration

2014 ◽  
Vol 24 (9) ◽  
pp. 1944-1950 ◽  
Author(s):  
Joshua P. Jarman ◽  
Volkan Emre Arpinar ◽  
Dhiraj Baruah ◽  
Andrew P. Klein ◽  
Dennis J. Maiman ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Disc Height ◽  
Height Loss ◽  
Pathological Changes ◽  
Intervertebral Disc Height
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