Kinetic magnetic resonance imaging analysis of abnormal segmental motion of the functional spine unit

2009 ◽  
Vol 10 (4) ◽  
pp. 357-365 ◽  
Author(s):  
Min Ho Kong ◽  
Henry J. Hymanson ◽  
Kwan Young Song ◽  
Dong Kyu Chin ◽  
Yong Eun Cho ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Disc Degeneration ◽  
Facet Joint ◽  
Sagittal Plane ◽  
Fatty Infiltration ◽  
Angular Motion ◽  
Segmental Motion ◽  
Paraspinal Muscles ◽  
Interspinous Ligament ◽  
The Relationship

Object The authors conducted a retrospective observational study using kinetic MR imaging to investigate the relationship between instability, abnormal sagittal segmental motion, and radiographic variables consisting of intervertebral disc degeneration, facet joint osteoarthritis (FJO), degeneration of the interspinous ligaments, ligamentum flavum hypertrophy (LFH), and the status of the paraspinal muscles. Methods Abnormal segmental motion, defined as > 10° angulation and > 3 mm of translation in the sagittal plane, was investigated in 1575 functional spine units (315 patients) in flexion, neutral, and extension postures using kinetic MR imaging. Each segment was assessed based on the extent of disc degeneration (Grades I–V), FJO (Grades 1–4), interspinous ligament degeneration (Grades 1–4), presence of LFH, and paraspinal muscle fatty infiltration observed on kinetic MR imaging. These factors are often noted in patients with degenerative disease, and there are grading systems to describe these changes. For the first time, the authors attempted to address the relationship between these radiographic observations and the effects on the motion and instability of the functional spine unit. Results The prevalence of abnormal translational motion was significantly higher in patients with Grade IV degenerative discs and Grade 3 arthritic facet joints (p < 0.05). In patients with advanced disc degeneration and FJO, there was a lesser amount of motion in both segmental translation and angulation when compared with lower grades of degeneration, and this difference was statistically significant for angular motion (p < 0.05). Patients with advanced degenerative Grade 4 facet joint arthritis had a significantly lower percentage of abnormal angular motion compared to patients with normal facet joints (p < 0.001). The presence of LFH was strongly associated with abnormal translational and angular motion. Grade 4 interspinous ligament degeneration and the presence of paraspinal muscle fatty infiltration were both significantly associated with excessive abnormal angular motion (p < 0.05). Conclusions This kinetic MR imaging analysis showed that the lumbar functional unit with more disc degeneration, FJO, and LFH had abnormal sagittal plane translation and angulation. These findings suggest that abnormal segmental motion noted on kinetic MR images is closely associated with disc degeneration, FJO, and the pathological characteristics of interspinous ligaments, ligamentum flavum, and paraspinal muscles. Kinetic MR imaging in patients with mechanical back pain may prove a valuable source of information about the stability of the functional spine unit by measuring abnormal segmental motion and grading of radiographic parameters simultaneously.

scholarly journals Motion characteristics and related factors of Modic changes in the lumbar spine

2015 ◽  
Vol 22 (5) ◽  
pp. 511-517 ◽  
Author(s):  
Tetsuo Hayashi ◽  
Michael D. Daubs ◽  
Akinobu Suzuki ◽  
Trevor P. Scott ◽  
Kevin H. Phan ◽  
...  
Keyword(s):  
Disc Degeneration ◽  
Translational Motion ◽  
Modic Changes ◽  
Angular Motion ◽  
Segmental Motion ◽  
Disc Disease ◽  
Motion Characteristics ◽  
Relationship Of ◽  
The Relationship

OBJECT Most studies of Modic changes (MCs) have focused on investigating the relationship between MCs and lowback pain, whereas the kinematic characteristics and degenerative disc disease associated with MCs are not well understood. To the authors' knowledge, no previous study has reported on the kinematics of MCs. The purpose of this study was to elucidate the relationship of MCs to segmental motion and degenerative disc disease. METHODS Four hundred fifty symptomatic patients underwent weight-bearing lumbar kinematic MRI in the neutral, flexion, and extension positions. Segmental displacement and intervertebral angles were measured in 3 positions using computer analysis software. Modic changes, disc degeneration, disc bulging, spondylolisthesis, angular motion, and translational motion were recorded, and the relationship of MCs to these factors was analyzed using a logistic regression model. To control the influence of disc degeneration on segmental motion, angular and translational motion were analyzed according to mild and severe disc degeneration stages. The motion characteristics and disc degeneration among types of MCs were also evaluated. RESULTS Multivariate analysis revealed that age, disc degeneration, angular motion, and translational motion were factors significantly related to MCs. In the severe disc degeneration stage, a significant decrease of angular motion and significant increase of translational motion were found in segments with MCs, indicating that a disorder of the endplate had an additional effect on segmental motion. Disc degeneration increased and angular motion decreased significantly and gradually as the type of MC increased. Translational motion was significantly increased with Type 2 MCs. CONCLUSIONS Age, disc degeneration, angular motion, and translational motion were significantly linked to MCs in the lumbar spine. The translational motion of lumbar segments increased with Type 2 MCs, whereas angular motion decreased as the type of MC increased, indicating that Type 2 MCs may have translational instability likely due to degenerative changes. A disorder of the endplates could play an important role in spinal instability.

scholarly journals The relationship between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI study

1999 ◽  
Vol 8 (5) ◽  
pp. 396-401 ◽  
Author(s):  
Atsushi Fujiwara ◽  
Kazuya Tamai ◽  
Minoru Yamato ◽  
Howard S. An ◽  
Hiroyuki Yoshida ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Disc Degeneration ◽  
Facet Joint ◽  
Facet Joint Osteoarthritis ◽  
Mri Study ◽  
The Relationship

The Relationship Between Disc Degeneration, Facet Joint Osteoarthritis, and Stability of the Degenerative Lumbar Spine

2000 ◽  
Vol 13 (5) ◽  
pp. 444-450 ◽  
Author(s):  
Atsushi Fujiwara ◽  
Kazuya Tamai ◽  
Howard S. An ◽  
Akira Kurihashi ◽  
Tae-Hong Lim ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Disc Degeneration ◽  
Facet Joint ◽  
Facet Joint Osteoarthritis ◽  
Degenerative Lumbar Spine ◽  
The Relationship

Effect of Different Types of Modic Changes on Segmental Motion and Disc Degeneration in Cervical Spine

2020 ◽  
Author(s):  
Fan Zhang ◽  
Jin Wang ◽  
Haocheng Xu ◽  
Feizhou Lyu
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Disc Degeneration ◽  
Modic Changes ◽  
Angular Motion ◽  
Segmental Motion ◽  
C7 Slope ◽  
Different Types ◽  
Close Relationship ◽  
Motion Characteristics

Abstract Background: Few studies have reported the segmental motion characteristics of different types of Modic changes (MCs) in the cervical spine in contrast to the lumbar spine. Considering the close relationship between MCs and disc degeneration (DD), this study is designed to elucidate the relationship of MCs with DD and DD-based angular motion in the cervical spine.Methods: MRI of C2/3~C6/7 from 594 patients were reviewed and those with MCs were selected and evaluated. MCs were defined as type 0, I, II, and III, and the grade of DD was classified from A to E (recorded from 1 to 5 points) as previously reported. DD score of each segment (sDD), total sDD of the entire cervical spine (tDD), and VAS score (neck pain) of each patient with MC were also recorded. Cervical lordosis (CL), C7 slope (C7S), segmental angular motion (sROM) and total angular motion of the entire cervical spine (tROM) were calculated from X-ray images.Results: Totally 135 MC segments were evaluated. In the two groups of DD D and DD E, the sROM of MC I and III segments are smaller than that of MC 0 segments, and the sROM of MC II segments are similar to that of MC 0. In addition, MC I segments present smaller sROM than that of MC II in the group of DD E, and their sROM are larger than that of MC III in the group of DD D. No difference is found in tROM between the patients with MC I, II and III. Our results also show that MC I and III segments are associated with high sDD and tDD scores. Finally, the patients with MC I have larger CL and C7S than those with MC III, and there is no statistical difference in VAS scores of neck pain between the patients with MC I, II and III. Conclusions: In the cervical spine, both MC I and III indicate decreased segmental angular motion and high disc degeneration grade. Cervical MCs may not be a sign of unstable neck pain or an indication for interbody fusion.

Magnetic resonance imaging grading of interspinous ligament degeneration of the lumbar spine and its relation to aging, spinal degeneration, and segmental motion

2010 ◽  
Vol 13 (4) ◽  
pp. 494-499 ◽  
Author(s):  
Gun Keorochana ◽  
Cyrus E. Taghavi ◽  
Shiau-Tzu Tzeng ◽  
Yuichiro Morishita ◽  
Jeong Hyun Yoo ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Elderly Patients ◽  
Facet Joint ◽  
Functional Unit ◽  
Grading System ◽  
Segmental Motion ◽  
Joint Degeneration ◽  
Significant Difference ◽  
Facet Joint Degeneration ◽  
Severe Grade

Object Degenerative changes of the interspinous ligaments (ISLs) have generally been ignored in previous studies. Factor-related causes, the effects that these changes have on other structures within the spinal functional unit, and their relation to kinematic changes in the spine are lacking. In this study, the authors evaluated the reliability of a proposed MR imaging grading system of ISL degeneration (ISLD). They also investigated the relationship between ISLD and aging, disc/facet joint degeneration, and lumbar segmental motion. Methods The authors studied 256 lumbar motion segments from L-2 to S-1 in 64 patients (35 men and 29 women) with a mean age of 46.08 years (range 23–85 years). An MR imaging–based grading system for ISLD was developed and ranged from Grade A (mild) to Grade D (severe). The reliability was tested, and the correlation of the grade with the severity of the disc and facet joint degeneration was examined. The segmental motion of each functional unit was measured using flexion/extension MR imaging, and their relationships with ISL grades were identified. Results Grade A was observed in 115 levels (44.9%), Grade B in 105 (41.0%), Grade C in 15 (5.9%), and Grade D in 21 levels (8.2%). The kappa coefficients for intraobserver and interobserver agreements were substantial to excellent (intraobserver [0.871] and interobserver [0.721–0.807]). Grade D was observed primarily in elderly patients. Segmental motion tended to decrease in the most severe grade, with a significant difference in angular mobility. As the severity of ISLD increased, the severity of disc/facet joint degeneration increased (p < 0.001 and p < 0.05, respectively). Conclusions The authors proposed a reliable and reproducible grading system that may be used to investigate spinal kinematics in association with ISLD. The authors' findings illustrated the distribution of ISLD grades. The most severe grade occurred primarily in elderly patients. Mobility decreased in the most severe grade; therefore, the stage of ISLD should be taken into consideration when evaluating spinal stability.

Correction of Posture Deviations in the Sagittal Plane Using the Pilates Method

2019 ◽  
pp. 3-13
Author(s):  
Alexandru Cîtea ◽  
George-Sebastian Iacob
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Postural Control ◽  
Human Body ◽  
Sagittal Plane ◽  
The Body ◽  
Lower Limbs ◽  
Low Back ◽  
Pilates Method ◽  
The Relationship

Posture is commonly perceived as the relationship between the segments of the human body upright. Certain parts of the body such as the cephalic extremity, neck, torso, upper and lower limbs are involved in the final posture of the body. Musculoskeletal instabilities and reduced postural control lead to the installation of nonstructural posture deviations in all 3 anatomical planes. When we talk about the sagittal plane, it was concluded that there are 4 main types of posture deviation: hyperlordotic posture, kyphotic posture, rectitude and "sway-back" posture.Pilates method has become in the last decade a much more popular formof exercise used in rehabilitation. The Pilates method is frequently prescribed to people with low back pain due to their orientation on the stabilizing muscles of the pelvis. Pilates exercise is thus theorized to help reactivate the muscles and, by doingso, increases lumbar support, reduces pain, and improves body alignment.

Association Between Deep Posterior Cervical Paraspinal Muscle Morphology and Clinical Features in Patients With Cervical Ossification of the Posterior Longitudinal Ligament

2021 ◽  
pp. 219256822198965
Author(s):  
Toru Doi ◽  
Nozomu Ohtomo ◽  
Fumihiko Oguchi ◽  
Keiichiro Tozawa ◽  
Hiroyuki Nakarai ◽  
...  
Keyword(s):  
Clinical Features ◽  
Fatty Infiltration ◽  
Neck Disability Index ◽  
Posterior Longitudinal Ligament ◽  
Paraspinal Muscle ◽  
Paraspinal Muscles ◽  
Muscle Area ◽  
Cross Sectional ◽  
Study Results ◽  
Neck Disability

Study Design: A retrospective observational study. Objective: To clarify the association of the paraspinal muscle area and composition with clinical features in patients with cervical ossification of the posterior longitudinal ligament (OPLL). Methods: Consecutive patients with cervical OPLL who underwent cervical magnetic resonance imaging (MRI) before surgery were reviewed. The cross-sectional area (CSA) and fatty infiltration ratio (FI%) of deep posterior cervical paraspinal muscles (multifidus [MF] and semispinalis cervicis [SCer]) were examined. We assessed the association of paraspinal muscle measurements with the clinical characteristics and clinical outcomes, such as Neck Disability Index (NDI) score. Moreover, we divided the patients into 2 groups according to the extent of the ossified lesion (segmental and localized [OPLL-SL] and continuous and mixed [OPLL-CM] groups) and compared these variables between the 2 groups. Results: 49 patients with cervical OPLL were enrolled in this study. The FI% of the paraspinal muscles was significantly associated with the number of vertebrae ( ρ = 0.283, p = 0.049) or maximum occupancy ratio of OPLL ( ρ = 0.397, p = 0.005). The comparative study results indicated that the NDI score was significantly worse (OPLL-SL, 22.9 ± 13.7 vs. OPLL-CM, 34.4 ± 13.7) and FI% of SCer higher (OPLL-SL, 9.1 ± 1.7% vs. OPLL-CM, 11.1 ± 3.7%) in the OPLL-CM group than those in the OPLL-SL group. Conclusions: Our results suggest that OPLL severity may be associated with fatty infiltration of deep posterior cervical paraspinal muscles, which could affect neck disability in patients with cervical OPLL.

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.

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