Twelve-Month Follow-up of Lumbar Spine Range of Motion Following Intervertebral Disc Replacement Using Radiostereometric Analysis

Study Design: Retrospective observational study. Objective: To investigate the relationship between the extent of ligament ossification and the range of motion (ROM) of the lumbar spine and develop a new scoring system. Methods: Forty-three patients (30 men and 13 women) with lumbar spinal canal stenosis who underwent decompression from January to December 2018. Ligament ossification at L1/2 to L5/S was assessed on plain X-ray (Xp) and computed tomography (CT) using a modified Mata scoring system (0 point: no ossification, 1 point: ossification of less than half of the intervertebral disc height, 2 points: ossification of half or more of the intervertebral disc height, 3 points: complete bridging), and the intra-rater and inter-rater reliability of the scoring was assessed. The relationship of the scores with postoperative lumbar ROM was investigated. Result: Intra-rater reliability was high (Cronbach’s α was 0.74 for L5/S on Xp but 0.8 or above for other sections), as was inter-rater reliability (Cronbach’s α was 0.8 or above for all the segments). ROM significantly decreased as the score increased (scores 1 to 2, and 2 to 3). A significant moderate negative correlation was found between the sum of the scores at L1/2-L5/S and the ROM at L1-S (ρ = − 0.4493, P = 0.025). Conclusion: Our scoring system reflects lumbar mobility and is reproducible. It is effective for assessing DISH in fractures and spinal conditions, and monitoring effects on treatment outcomes and changes over time.

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An Eight‐Year Follow‐Up Study on the Treatment of Single‐Level Cervical Spondylosis Through Intervertebral Disc Replacement and Anterior Cervical Decompression and Fusion

Orthopaedic Surgery ◽

10.1111/os.12634 ◽

2020 ◽

Vol 12 (3) ◽

pp. 717-726

Author(s):

Hao Guo ◽

Jun Sheng ◽

Wei‐Bin Sheng ◽

Wei‐Dong Liang ◽

Jian Wang ◽

...

Keyword(s):

Intervertebral Disc ◽

Cervical Spondylosis ◽

Disc Replacement ◽

Single Level ◽

Follow Up Study ◽

Anterior Cervical Decompression

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RSA in Spine: A Review

Global Spine Journal ◽

10.1177/2192568217701722 ◽

2017 ◽

Vol 7 (8) ◽

pp. 811-820 ◽

Cited By ~ 4

Author(s):

Ali Humadi ◽

Sulaf Dawood ◽

Klas Halldin ◽

Brian Freeman

Keyword(s):

Systematic Review ◽

Lumbar Spine ◽

Range Of Motion ◽

Rigid Bodies ◽

Review Of Literature ◽

Radiostereometric Analysis ◽

Specific Knowledge ◽

Spinal Motion ◽

Vertebral Segment

Study Design: Systematic review of literature. Objectives: This systematic review was conducted to investigate the accuracy of radiostereometric analysis (RSA), its assessment of spinal motion and disorders, and to investigate the limitations of this technique in spine assessment. Methods: Systematic review in all current literature to invesigate the role of RSA in spine. Results: The results of this review concluded that RSA is a very powerful tool to detect small changes between 2 rigid bodies such as a vertebral segment. The technique is described for animal and human studies for cervical and lumbar spine and can be used to analyze range of motion, inducible displacement, and fusion of segments. However, there are a few disadvantages with the technique; RSA percutaneous procedure needs to be performed to implant the markers (and cannot be used preoperatively), one needs a specific knowledge to handle data and interpret the results, and is relatively time consuming and expensive. Conclusions: RSA should be looked at as a very powerful research instrument and there are many questions suitable for RSA studies.

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Changes in cervical range of motion and sagittal alignment in early and late phases after total disc replacement: radiographic follow-up exceeding 2 years

Journal of Neurosurgery Spine ◽

10.3171/2009.7.spine0946 ◽

2009 ◽

Vol 11 (6) ◽

pp. 688-695 ◽

Cited By ~ 26

Author(s):

Poong-Gi Ahn ◽

Keung Nyun Kim ◽

Sung Whan Moon ◽

Keun Su Kim

Keyword(s):

Cobb Angle ◽

Range Of Motion ◽

Early Phase ◽

Sagittal Alignment ◽

Late Phase ◽

Total Disc Replacement ◽

Disc Replacement ◽

Cage Group ◽

Adjacent Segments

Object This was a retrospective clinical study in which the follow-up period exceeded 2 years. The authors investigated the time course of radiographic changes in the cervical range of motion (ROM) and sagittal alignment after cervical total disc replacement involving the ProDisc-C artificial disc. Methods Eighteen patients who underwent C5–6 total disc replacement were followed for an average of 27 months. Cervical neutral and flexion-extension lateral radiographs were obtained before and at 1 and 3 months after surgery for early-phase observations and at the last follow-up for late-phase observation. Segmental ROM values in the treated, superior, and inferior adjacent segments were measured. For whole-neck motion, C2–7 ROM was also measured. The percentage contributions of ROM at functional and adjacent segments to whole-neck motion were calculated. For evaluating sagittal alignment, C2–7 and C5–6 Cobb angles were measured. All data from ProDisc-C arthroplasty were compared with the results obtained in 22 patients who underwent C5–6 interbody fusion in which a Solis cage was used and who were followed for an average of 25 months Results In the ProDisc-C group, C2–7 and C5–6 ROM significantly decreased in the early phase after surgery and returned to preoperative levels in the late phase. Both superior and inferior adjacent segments showed significantly decreased ROM in the acute phase after surgery and returned to the preoperative values in the late phase. In terms of contributions to whole-neck motion, the ROM of the functional and adjacent segments did not change significantly compared with the preoperative ROM. In the cage group, C2–7 ROM was also significantly decreased in the early phase after surgery and returned to preoperative levels at the late phase. Both superior and inferior adjacent segments exhibited significantly increased ROM and percentage contributions to whole-neck motion in the early and late phases. Sagittal alignment of the whole cervical spine became significantly more lordotic in the late phase in the ProDisc-C group. The C5–6 Cobb angle became significantly lordotic in the ProDisc-C group, whereas there was no significant change in C5–6 Cobb angle in the cage group. Conclusions In the early phase after ProDisc-C replacement, the ROM of the entire neck as well as functional and adjacent segments decreased but, at the late phase, they returned to the preoperative state. Contributions of functional and adjacent segments to whole-neck motion were not changed after ProDisc-C replacement. Adjacent-segmental motion could be saved by ProDisc-C replacement instead of interbody cage fusion. Segmental degenerative kyphosis was significantly corrected in patients who underwent ProDisc-C replacement.

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