Predictors of L4−L5 Degenerative Lumbar Spondylolisthesis: L4 Inclination Angle and Facet Joint Angle

2019 ◽  
Vol 130 ◽  
pp. e680-e686 ◽  
Author(s):  
Machao Guo ◽  
Chao Kong ◽  
Siyuan Sun ◽  
Xiangyao Sun ◽  
Xiangyu Li ◽  
...  
Keyword(s):  
Inclination Angle ◽  
Joint Angle ◽  
Facet Joint ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis

POSTERIOR ELEMENT MORPHOLOGY AND DEGENERATIVE LUMBAR SPONDYLOLISTHESIS

2015 ◽  
Vol 18 (01) ◽  
pp. 1550001
Author(s):  
Myung-Sang Moon ◽  
Min-Keun Yoon ◽  
Ki-Tae Kwon ◽  
Min-Suk Park ◽  
Bong-Keun Park ◽  
...  
Keyword(s):  
Inclination Angle ◽  
Facet Joint ◽  
Degenerative Spondylolisthesis ◽  
Predisposing Factor ◽  
Lower Lumbar Spine ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Inclination Angles ◽  
Grade Ii ◽  
Lower Lumbar ◽  
Lumbar Spondylolisthesis

Study design: Retrospective radiographic studies on lumbar facet morphology, and facet and laminar inclination angles. Objectives: To investigate the effect of the facet morphology, facet and laminar inclination angles on development of the segmental instability and spondylolisthesis. Summary of background data: Many previous papers related with the facet shape on pathogenesis of the degenerative instability and spondylolisthesis were published. Most authors interpreted that the facet morphology in the pathogenesis of the spondylolisthesis was a factor secondary to facet joint osteoarthritis, and was not the primary one. None dealt the effect of facet shape and laminar inclination on slippage severity. Method: The subject materials were 50 patients (10 males and 40 females) with degenerative spondylolisthesis, treated between 1999 and 2013. Simple radiograms were utilized for assessment. Facet joints were classified by Tsunoda et al., based on its developmental shape and alignment on radiograms; X, M, and W types. Also the laminar inclination and facet inclination angles were measured. Results: Among 50 patients 45 had anterolisthesis with (forward flexion instability) and only five had retrolisthesis (extension instability). In 45 cases of anterolisthesis, there were 24 "X" types, 4 "M" types, and 17 "W" types, while in 5 cases of retrolisthesis there were 3 "X" and 2 "M" types. In 45 cases of anterolisthesis, 24 with "X" type facets had Myerding's grade I slip, and one had grade II slip; Among the 4 "M" types two had grade I slip and two had grade II slip, while among 17 "W" type, there were four grade I slip, 11 grade II slip, and two grade III slip. 13 out of the 16 anterolisthesis over grade II slip had "W" type facets. Vertebra with "W" type facets had average 130° laminar inclination angle and 122° facet inclination angles, while "X" and "M" type facets had less inclination of both angles. Conclusion: The defective facet morphology and laminar inclination angle of the lower lumbar spine can be the predisposing factor of development and slip progress of the degenerative anterolisthesis.

scholarly journals Multivariate analysis of pedicle screw invasion of the proximal facet joint after lumbar surgery

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Peng Tao Wang ◽  
Jia Nan Zhang ◽  
Tuan Jiang Liu ◽  
Jun Song Yang ◽  
Ding Jun Hao
Keyword(s):  
Risk Factors ◽  
Pedicle Screw ◽  
Joint Angle ◽  
Facet Joint ◽  
Lumbar Surgery ◽  
Lower Lumbar Spine ◽  
Significant Difference ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lower Lumbar ◽  
Lumbar Spondylolisthesis

Abstract Background To analyze the risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery. Methods From January 2019 to January 2021, 1794 patients with lumbar degenerative disease, such as lumbar disc herniation, lumbar spinal stenosis and lumbar spondylolisthesis, were treated at our hospital. In all, 1221 cases were included. General data (sex, age, BMI), bone mineral density, proximal facet joint angle, degenerative lumbar spondylolisthesis, isthmic lumbar spondylolisthesis and fixed segment in the two groups were recorded. After the operation, vertebral CT of the corresponding surgical segments was performed for three-dimensional reconstruction and evaluation of whether the vertebral arch root screw interfered with the proximal facet joint. The included cases were divided into an invasion group and a noninvasion group. Univariate analysis was used to screen the risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery, and the selected risk factors were included in the logistic model for multivariate analysis. Results The single-factor analysis showed a significant difference in age, BMI, proximal facet joint angle, degenerative lumbar spondylolisthesis, and fixed segment (P < 0.1). Multifactor analysis of the logistic model showed a significant difference for age ≥ 50 years (P < 0.001, OR = 2.291), BMI > 28 kg/m2 (P < 0.001, OR = 2.548), degenerative lumbar spondylolisthesis (P < 0.001, OR = 2.187), gorge cleft lumbar relaxation (P < 0.001, OR = 2.410), proximal facet joint angle (35 ~ 45°: P < 0.001, OR = 3.151; > 45°: P < 0.001, OR = 3.578), and fixed segment (lower lumbar spine: P < 0.001, OR = 2.912). Conclusion Age (≥ 50 years old), BMI (> 28 kg/m2), proximal facet joint angle (35 ~ 45°, > 45°), degenerative lumbar spondylolisthesis, isthmic lumbar spondylolisthesis and fixed segment (lower lumbar spine) are independent risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery. Compared with degenerative lumbar spondylolisthesis, facet joint intrusion is more likely in isthmic lumbar spondylolisthesis.

Radiographic evaluation of postoperative bone regrowth after microscopic bilateral decompression via a unilateral approach for degenerative lumbar spondylolisthesis

2013 ◽  
Vol 18 (5) ◽  
pp. 472-478 ◽  
Author(s):  
Sho Dohzono ◽  
Akira Matsumura ◽  
Hidetomi Terai ◽  
Hiromitsu Toyoda ◽  
Akinobu Suzuki ◽  
...  
Keyword(s):  
Facet Joint ◽  
Contralateral Side ◽  
Facet Joints ◽  
Joint Preservation ◽  
Unilateral Approach ◽  
Degenerative Lumbar Spondylolisthesis ◽  
The Difference ◽  
Lumbar Spondylolisthesis ◽  
Bone Regrowth

Object Minimally invasive decompressive surgery using a microscope or endoscope has been widely performed for the treatment of lumbar spinal canal stenosis (LSS). In this study the authors aimed to assess outcomes following microscopic bilateral decompression via a unilateral approach (MBDU) in terms of postoperative bone regrowth and preservation of the facet joints in patients with degenerative lumbar spondylolisthesis (DS) as compared with those in patients with LSS. Methods In the period from May 1998 to February 2007 at the authors' institution, 85 patients underwent MBDU at L4–5. Clinical outcome was evaluated before surgery and at the final follow-up using the Japanese Orthopaedic Association (JOA) score for low-back pain. The following radiographic parameters were assessed at the L4–5 segment before surgery and at the final follow-up: 1) percentage slip on standing lateral radiographs, 2) percentage slip on dynamic radiographs, 3) disc arc on dynamic radiographs, and 4) percentage of facet joint preservation on CT. Bone regrowth on the ventral and dorsal sides of the facet joint on CT were assessed at the final follow-up. Results The cases of 47 patients (23 with DS at L-4 and 24 with LSS at L4–5 without instability) who had a follow-up of at least 2 years were retrospectively reviewed. The improvement ratio in the JOA score, that is, the percentage improvement as indicated by the difference between preoperative and postoperative JOA scores, was not significantly different between patients with DS and LSS. The percentage slip had progressed at the latest follow-up in both groups (1.4% and 1.1%, respectively), and there was no significant difference between the 2 groups. The percentage of facet joint preservation in the DS and LSS groups was 72.8% and 83.4%, respectively, on the approach side and 95.5% and 96.5% on the contralateral side. Facet joint preservation was significantly less on the approach side than on the contralateral side in both groups. The average amount of bone regrowth on the dorsal and ventral sides of the facet joint was 3.4 and 0.9 mm, respectively, in the DS group and 2.0 and 1.0 mm in the LSS group. The difference between the 2 groups was not significant. Facet joint preservation and bone regrowth were not correlated with clinical outcomes. Conclusions Microscopic bilateral decompression via a unilateral approach can prevent postoperative spinal instability because of good preservation of the posterior elements including the facet joints, which is thought to be the main reason for the relatively small amount of bone regrowth after surgery.

scholarly journals Association of Lumbar Paraspinal Muscle Morphometry with Degenerative Spondylolisthesis

2021 ◽  
Vol 18 (8) ◽  
pp. 4037
Author(s):  
Eun Taek Lee ◽  
Seung Ah Lee ◽  
Yunsoo Soh ◽  
Myung Chul Yoo ◽  
Jun Ho Lee ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Protective Factor ◽  
Degenerative Spondylolisthesis ◽  
Fatty Degeneration ◽  
Erector Spinae ◽  
Cross Sectional ◽  
Skeletal Muscle Index ◽  
Fat Infiltration ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis

The objective of this study was to assess the cross-sectional areas (CSA) of lumbar paraspinal muscles and their fatty degeneration in adults with degenerative lumbar spondylolisthesis (DLS) diagnosed with chronic radiculopathy, compare them with those of the same age- and sex-related groups with radiculopathy, and evaluate their correlations and the changes observed on magnetic resonance imaging (MRI). This retrospective study included 62 female patients aged 65–85 years, who were diagnosed with lumbar polyradiculopathy. The patients were divided into two groups: 30 patients with spondylolisthesis and 32 patients without spondylolisthesis. We calculated the CSA and fatty degeneration of the erector spinae (ES) and multifidus (MF) on axial T2-weighted magnetic resonance (MR) images from the inferior end plate of the L4 vertebral body levels. The functional CSA (FCSA): CSA ratio, skeletal muscle index (SMI), and MF CSA: ES CSA ratio were calculated and compared between the two groups using an independent t-test. We performed logistic regression analysis using spondylolisthesis as the dependent variable and SMI, FCSA, rFCSA, fat infiltration rate as independent variables. The result showed more fat infiltration of MF in patients with DLS (56.33 vs. 44.66%; p = 0.001). The mean FCSA (783.33 vs. 666.22 mm2; p = 0.028) of ES muscle was a statistically larger in the patients with DLS. The ES FCSA / total CSA was an independent predictor of lumbar spondylolisthesis (odd ratio =1.092, p = 0.016), while the MF FCSA / total CSA was an independent protective factor (odd ratio =0.898, p = 0.002)

P68. Mid-Term Clinical Outcome of Posterior Decompression Without Fusion for Degenerative Lumbar Spondylolisthesis

2006 ◽  
Vol 6 (5) ◽  
pp. 116S
Author(s):  
Keigo Yasui ◽  
Manabu Ito ◽  
Kuniyoshi Abumi ◽  
Yoshihisa Kotani ◽  
Jun-Ichiro Okumura ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Posterior Decompression ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis

scholarly journals Degenerative Lumbar Spondylolisthesis with Spinal Stenosis: A Comparative Study of 5-Year Outcomes Following Decompression with Fusion and Microendoscopic Decompression

2018 ◽  
Vol 12 (1) ◽  
pp. 132-139 ◽  
Author(s):  
Takato Aihara ◽  
Tomoaki Toyone ◽  
Yasuaki Murata ◽  
Kazuhide Inage ◽  
Makoto Urushibara ◽  
...  
Keyword(s):  
Back Pain ◽  
Clinical Outcomes ◽  
Japanese Orthopaedic Association ◽  
Large Percentage ◽  
Neutral Position ◽  
Maximal Extension ◽  
Surgical Methods ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Functional Scores ◽  
Lumbar Spondylolisthesis

<sec><title>Study Design</title><p>Retrospective review of prospectively collected outcome data.</p></sec><sec><title>Purpose</title><p>To compare 5-year outcomes following decompression with fusion (FU) and microendoscopic decompression (MED) in patients with degenerative lumbar spondylolisthesis (DLS) and to define surgical indication limitations regarding the use of MED for this condition.</p></sec><sec><title>Overview of Literature</title><p>There have been no comparative studies on mid- or long-term outcomes following FU and MED for patients with DLS.</p></sec><sec><title>Methods</title><p>Forty-one consecutive patients with DLS were surgically treated. Sixteen patients first underwent FU (FU group), and 25 then underwent MED (MED group). The 5-year clinical outcomes following the two surgical methods were compared using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire.</p></sec><sec><title>Results</title><p>The degree of improvement (DOI) for social life function was significantly greater in the MED group than in the FU group. Although not statistically significant, DOIs for the other four functional scores were also greater in the MED group than in the FU group. However, patients with a large percentage of slippage in the neutral position might experience limited improvement in low back pain, those with a large percentage of slippage at maximal extension might experience limited improvement in three functional scores, and those with a small intervertebral angle at maximal flexion might have limited improvement in three functional scores after MED for DLS. Therefore, we statistically compared the DOIs between the FU and MED groups regarding the preoperative percentage of slippage in the neutral position among patients with greater than 20% slippage, the preoperative percentage of slippage at maximal extension among patients with greater than 15% slippage, and the intervertebral angle at flexion among patients with angles lesser than −5°; however, there were no statistically significant differences between the two groups.</p></sec><sec><title>Conclusions</title><p>MED is a useful minimally invasive surgical procedure that possibly offers better clinical outcomes than FU for DLS.</p></sec>

scholarly journals GUIDELINES FOR TREATMENT OF DEGENERATIVE LUMBAR SPONDYLOLISTHESIS

2016 ◽  
Vol 15 (3) ◽  
pp. 238-240 ◽  
Author(s):  
CARMEN YOSSALETH BRICEÑO-GONZÁLEZ ◽  
ADRIÁN GARCÍA-SUAREZ ◽  
EULALIO ELIZALDE-MARTÍNEZ ◽  
MARIO ANTONIO DOMÍNGUEZ-DE LA PEÑA ◽  
RUBÉN TORRES-GONZÁLEZ ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Treatment Options ◽  
Cross Sectional ◽  
Practice Guide ◽  
Transpedicular Instrumentation ◽  
Clinical Presentations ◽  
Study Results ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Axial Symptoms ◽  
Lumbar Spondylolisthesis

ABSTRACT Objectives: To determine the standard of treatment of degenerative lumbar spondylolisthesis in its different clinical presentations in UMAE Dr. Victorio de la Fuente Narváez. Methods: Six cases found in the literature were presented to 36 experts in spine surgery, along with treatment options, to thereby obtain a standard prescription for the treatment of degenerative lumbar spondylolisthesis. Analytical observational cross-sectional descriptive study. Results: It was found that the treatment of choice in cases of degenerative lumbar spondylolisthesis with axial symptoms is conservative. The surgical treatment of choice for both stable and unstable patients with radiculopathy and/or claudication is decompression + posterolateral graft + transpedicular instrumentation + discectomy (graft). Conclusions: We managed to define the degenerative lumbar spondylolisthesis treatment guidelines in our unit, which can serve as a basis for the development of a clinical practice guide.

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