Effect of the Increase in the Height of Lumbar Disc Space on Facet Joint Articulation Area in Sagittal Plane

Spine ◽  
2006 ◽  
Vol 31 (7) ◽  
pp. E198-E202 ◽  
Author(s):  
Jiayong Liu ◽  
Nabil A. Ebraheim ◽  
Steven P. Haman ◽  
Qaiser Shafiq ◽  
Nakul Karkare ◽  
...  
Keyword(s):  
Facet Joint ◽  
Sagittal Plane ◽  
Lumbar Disc ◽  
Disc Space

P45. How Increasing Lumbar Disc Space Height Affects the Lumbar Facet Joint

2006 ◽  
Vol 6 (5) ◽  
pp. 105S-106S
Author(s):  
Jiayong Liu ◽  
Nabil A. Ebraheim ◽  
Steve P. Haman ◽  
Chris G. Sanford ◽  
Richard A. Yeasting
Keyword(s):  
Facet Joint ◽  
Lumbar Disc ◽  
Lumbar Facet Joint ◽  
Disc Space ◽  
Lumbar Facet

scholarly journals The Association Between Sagittal Plane Alignment and Disc Space Narrowing of Lumbar Spine in Farmers

2021 ◽  
Vol 45 (4) ◽  
pp. 294-303
Author(s):  
Ki Hoon Park ◽  
Sora Baek ◽  
Eun Kyoung Kang ◽  
Hee-won Park ◽  
Gowun Kim ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
Lumbar Disc ◽  
Age Groups ◽  
Low Back ◽  
Disc Space Narrowing ◽  
Disc Space ◽  
Lateral Spine ◽  
Spine Radiograph ◽  
Segmental Lordosis ◽  
Disc Level

Objective To investigate whether lumbar lordosis (LL) and lumbar segmental lordosis (LSL) are related to sex, age, low back pain (LBP), and lumbar disc space narrowing (DSN).Methods A total of 569 farmers were recruited. In lateral spine radiograph, LL (L1–L5) and LSL (L1, L2, L3, L4, and L5) were measured using Cobb’s method. The differences in LSL values (ΔLSL) according to the presence or absence of a DSN were calculated as LSLDSN – LSLnoDSN for each DSN level.Results In male, the lateral spine radiograph showed significantly greater L4-LSL and L5-LSL and smaller L1-LSL and L2-LSL compared to female. LLs in the 50–59 and ≥60 years age groups were significantly smaller compared to those in the <50 years age group. In subjects with LBP, LL and L4-LSL were significantly smaller than in those without. The ΔLSLs at the disc level with DSN showed the greatest decrease: L1-ΔLSL (Δ-3.99°), L2-ΔLSL (Δ-3.31°), L3-ΔLSL (Δ-2.87°), L4-ΔLSL (Δ-3.31°), and L5-ΔLSL (Δ-4.44°) in L1/2, L2/3, L3/4, L4/5, and L5/S1 DSN, respectively. Conversely, distant ΔLSLs were inversely increased: L1-LSL (Δ0.75°) with L4/5 DSN and L2-LSL (Δ0.94°) with L5/S1 DSN.Conclusion Sagittal plane alignment was significantly associated with sex, age, LBP, and DSN. LSLs around the levels of DSN were decreased, and there was compensational increase of LSL distant to the DSN to maintain the overall LL.

scholarly journals Microendoscopy-assisted extraforaminal lumbar interbody fusion for treating single-level spondylodesis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Motohide Shibayama ◽  
Guang Hua Li ◽  
Li Guo Zhu ◽  
Zenya Ito ◽  
Fujio Ito
Keyword(s):  
Minimally Invasive ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Facet Joint ◽  
Clinical Results ◽  
Invasive Technique ◽  
Clinical Effects ◽  
Lumbar Interbody Fusion ◽  
Disc Space ◽  
Single Level

Abstract Background Lumbar interbody fusion is a standard technique for treating degenerative lumbar disorders involving instability. Due to its invasiveness, a minimally invasive technique, extraforaminal lumbar interbody fusion (ELIF), was introduced. On surgically approaching posterolaterally, the posterior muscles and spinal canal are barely invaded. Despite its theoretical advantage, ELIF is technically demanding and has not been popularised. Therefore, we developed a microendoscopy-assisted ELIF (mELIF) technique which was designed to be safe and less invasive. Here, we aimed to report on the surgical technique and clinical results. Methods Using a posterolateral approach similar to that of lateral disc herniation surgery, a tubular retractor, 16 or 18 mm in diameter, was placed at the lateral aspect of the facet joint. The facet joint was partially excised, and the disc space was cleaned. A cage and local bone graft were inserted into the disc space. All disc-related procedures were performed under microendoscopy. The spinal canal was not invaded. Bilateral percutaneous screw-rod constructs were inserted and fixed. Results Fifty-five patients underwent the procedure. The Oswestry Disability Index and visual analogue scale scores greatly improved. Over 90% of the patients obtained excellent or good results based on Macnab’s criteria. There were neither major adverse clinical effects nor the need for additional surgery. Conclusions mELIF is minimally invasive because the spinal canal and posterior muscles are barely invaded. It produces good clinical results with fewer complications. This technique can be applied in most single-level spondylodesis cases, including those involving L5/S1 disorders.

scholarly journals Frisbee - the first artificial cervical disc of 3RD generation

2014 ◽  
Vol 13 (1) ◽  
pp. 43-48
Author(s):  
Karin Büttner-Janz ◽  
Bernhard Meyer ◽  
Rafael Donatus Sambale ◽  
Hans-Joachim Wilke ◽  
Nelli Rüdiger ◽  
...  
Keyword(s):  
Heterotopic Ossification ◽  
Clinical Application ◽  
Wear Debris ◽  
Facet Joint ◽  
Sagittal Plane ◽  
Joint Surface ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Fe Model ◽  
Sliding Surface

OBJECTIVE: The current cervical disc arthroplasty is limited by postoperative facet joint arthritis, heterotopic ossification and segmental kyphosis. The total Frisbee disc, which has an upper convex/concave non-spherical surface and a lower flat sliding surface, is a new approach for improved outcomes. Prior to clinical application, safety and suitability tests are required. METHODS: The Frisbee is the first 3rd generation disc according to a new classification of total disc because it can precisely mimic the segmental ROM, including the soft limitation of axial rotation. The ISO 18192-1 test was carried out to determine the rate of wear debris. A FE model was used to assess the safety of prosthetic components. In the sagittal plane several variables to determine the most favorable lordotic angle were evaluated. RESULTS: Two angled prosthetic plates are safer than one sliding angled core to prevent the displacement. The lordosis of 7° of the Frisbee leads to kyphosis of no more than 2° without reduction of the ROM. The wear rate of the Frisbee is five times smaller compared to an FDA-approved disc with a spherical sliding surface. CONCLUSIONS: Based on the test results, the clinical application of Frisbee can now be studied. The postoperative kyphosis observed with other devices is not an issue with the Frisbee design. Physiological ROM is combined with the significant reduction of wear debris. For these reasons the Frisbee has the potential to provide a better balanced segmental loading reducing the degeneration of the joint surface and heterotopic ossification.

Diagnosis and microsurgical approach to far-lateral disc herniation in the lumbar spine

1990 ◽  
Vol 72 (3) ◽  
pp. 378-382 ◽  
Author(s):  
Joseph C. Maroon ◽  
Thomas A. Kopitnik ◽  
Larry A. Schulhof ◽  
Adnan Abla ◽  
James E. Wilberger
Keyword(s):  
Facet Joint ◽  
Lumbar Disc ◽  
Spinal Nerve ◽  
Magnetic Resonance Images ◽  
Content Type ◽  
Enhanced Ct ◽  
Disc Herniations ◽  
Microsurgical Approach ◽  
Far Lateral ◽  
Fine Print

✓ Lumbar-disc herniations that occur beneath or far lateral to the intervertebral facet joint are increasingly recognized as a cause of spinal nerve root compression syndromes at the upper lumbar levels. Failure to diagnose and precisely localize these herniations can lead to unsuccessful surgical exploration or exploration of the incorrect interspace. If these herniations are diagnosed, they often cannot be adequately exposed through the typical midline hemilaminectomy approach. Many authors have advocated a partial or complete unilateral facetectomy to expose these herniations, which can lead to vertebral instability or contribute to continued postoperative back pain. The authors present a series of 25 patients who were diagnosed as having far lateral lumbar disc herniations and underwent paramedian microsurgical lumbar-disc excision. Twelve of these were at the L4–5 level, six at the L5–S1 level, and seven at the L3–4 level. In these cases, myelography is uniformly normal and high-quality magnetic resonance images may not be helpful. High-resolution computerized tomography (CT) appears to be the best study, but even this may be negative unless enhanced by performing CT-discography. Discography with enhanced CT is ideally suited to precisely diagnose and localize these far-lateral herniations. The paramedian muscle splitting microsurgical approach was found to be the most direct and favorable anatomical route to herniations lateral to the neural foramen. With this approach, there is no facet destruction and postoperative pain is minimal. Patients were typically discharged on the 3rd or 4th postoperative day. The clinical and radiographic characteristics of far-lateral lumbar-disc herniations are reviewed and the paramedian microsurgical approach is discussed.

Neurovascular structures adjacent to the lumbar intervertebral discs: an anatomical study of their morphometry and relationships

2011 ◽  
Vol 14 (5) ◽  
pp. 630-638 ◽  
Author(s):  
Mehmet Arslan ◽  
Ayhan Cömert ◽  
Halil İbrahim Açar ◽  
Mevci Özdemir ◽  
Alaittin Elhan ◽  
...  
Keyword(s):  
Nerve Root ◽  
Lumbar Disc ◽  
Anatomical Study ◽  
Intervertebral Discs ◽  
Nerve Roots ◽  
Disc Space ◽  
Anatomical Knowledge ◽  
The Mean ◽  
The Right ◽  
Neurovascular Structures

Object Although infrequent, injury to adjacent neurovascular structures during posterior approaches to lumbar intervertebral discs can occur. A detailed anatomical knowledge of relationships may decrease surgical complications. Methods Ten formalin-fixed male cadavers were used for this study. Posterior exposure of the lumbar thecal sac, nerve roots, pedicles, and intervertebral discs was performed. To identify retroperitoneal structures at risk during posterior lumbar discectomy, a transabdominal retroperitoneal approach was performed, and observations were made. The distances between the posterior and anterior edges of the lumbar intervertebral discs were measured, and the relationships between the disc space, pedicle, and nerve root were evaluated. Results For right and left sides, the mean distance from the inferior pedicle to the disc gradually increased from L1–2 to L4–5 (range 2.7–3.8 mm and 2.9–4.5 mm for right and left side, respectively) and slightly decreased at L5–S1. For right and left sides, the mean distance from the superior pedicle to the disc was more or less the same for all disc spaces (range 9.3–11.6 mm and 8.2–10.5 mm for right and left, respectively). The right and left mean disc-to-root distance for the L3–4 to L5–S1 levels ranged from 8.3 to 22.1 mm and 7.2 to 20.6 mm, respectively. The root origin gradually increased from L-1 to L-5. The right and left nerve root–to-disc angle gradually decreased from L-3 to S-1 (range 105°–110.6° and 99°–108°). Disc heights gradually increased from L1–2 to L5–S1 (range 11.3–17.4 mm). The mean distance between the anterior and posterior borders of the intervertebral discs ranged from 39 to 46 mm for all levels. Conclusions To avoid neighboring neurovascular structures, instrumentation should not be inserted into the lumbar disc spaces more than 3 cm from their posterior edge. Accurate anatomical knowledge of the relationships of intervertebral discs to nerve roots is needed for spine surgeons.

Alteration of Facet Joint Orientation and Asymmetry With Time in Lumbar Disc Herniation

2006 ◽  
Vol 16 (3) ◽  
pp. 135-138 ◽  
Author(s):  
Ilhan Karacan ◽  
Teoman Aydin ◽  
Muharrem Cidem ◽  
Safak Sahir Karamehmetoglu
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Joint Orientation

Posterior Epidural Migration of Sequestrated Lumbar Disc Fragments Into the Bilateral Facet Joints

Neurosurgery ◽  
2011 ◽  
Vol 69 (5) ◽  
pp. E1148-E1151 ◽  
Author(s):  
Tzuu-Yuan Huang ◽  
Kung-Shing Lee ◽  
Tai-Hsin Tsai ◽  
Yu-Feng Su ◽  
Shiuh-Lin Hwang
Keyword(s):  
Differential Diagnosis ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Synovial Cyst ◽  
Leg Pain ◽  
Hybrid Technique ◽  
Facet Joints ◽  
Disc Disease ◽  
First Case ◽  
Rod System

Abstract BACKGROUND AND IMPORTANCE Symptomatic lumbar disc herniation is common. Migration of a free disc fragment is usually found in rostral, caudal, or lateral directions. Posterior epidural migration is very rare. We report the first case with posterior epidural migration and sequestration into bilateral facet joints of a free disc fragment. CLINICAL PRESENTATION A 78-year-old female presented with low back pain and right leg pain. Plain radiographs showed lumbar spondylolisthesis. Magnetic resonance imaging revealed a posterior epidural mass and intrafacet mass, which was hypointense on T1-weighted images and hyperintense on T2-weighted images. The lesion in the left L3-4 facet joint had rim enhancement, whereas the right one was not contrasted after gadolinium injection. Preoperative differential diagnosis included abscess, tumor, hematoma, or synovial cyst. An interbody cage fusion at L3-4 and L4-5 for spondylolisthesis was performed, and a hybrid technique was applied with the Dynesys flexible rod system at L3-S1 for multisegment degenerative disc disease. The lesion proved to be an epidural disc fragment with sequestration into bilateral facet joints. CONCLUSION A free disc fragment should be considered in the differential diagnosis of posterior epidural lesions, and even in the facet joint.

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