Skip to main content
SpringerLink
Log in

Motion characteristics of the vertebral segments with lumbar degenerative spondylolisthesis in elderly patients

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Objective

Although some studies have reported on the kinematics of the lumbar segments with degenerative spondylolisthesis (DS), few data have been reported on the in vivo 6 degree-of-freedom kinematics of different anatomical structures of the diseased levels under physiological loading conditions. This research is to study the in vivo motion characteristics of the lumbar vertebral segments with L4 DS during weight-bearing activities.

Methods

Nine asymptomatic volunteers (mean age 54.4) and 9 patients with L4 DS (mean age 73.4) were included. Vertebral kinematics was obtained using a combined MRI/CT and dual fluoroscopic imaging technique. During functional postures (supine, standing upright, flexion, and extension), disc heights, vertebral motion patterns and instability were compared between the two groups.

Results

Although anterior disc heights were smaller in the DS group than in the normal group, the differences were only significant at standing upright. Posterior disc heights were significantly smaller in DS group than in the normal group under all postures. Different vertebral motion patterns were observed in the DS group, especially in the left–right and cranial–caudal directions during flexion and extension of the body. However, the range of motions of the both groups were much less than the reported criteria of lumbar spinal instability.

Conclusion

The study showed that lumbar vertebra with DS has disordered motion patterns. DS did not necessary result in vertebral instability. A restabilization process may have occurred and surgical treatment should be planned accordingly.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Iguchi T, Wakami T, Kurihara A et al (2002) Lumbar multilevel degenerative spondylolisthesis: radiological evaluation and factors related to anterolisthesis and retrolisthesis. J Spinal Disord Tech 15:93–99

    Article  PubMed  Google Scholar 

  2. Sengupta DK, Herkowitz HN (2005) Degenerative spondylolisthesis: review of current trends and controversies. Spine 15:S71–S81

    Article  Google Scholar 

  3. Berlemann U, Jeszenszky DJ, Bühler DW et al (1999) The role of lumbar lordosis, vertebral end-plate inclination, disc height, and facet orientation in degenerative spondylolisthesis. J Spinal Disord 12:68–73

    Article  PubMed  CAS  Google Scholar 

  4. Nagaosa Y, Kikuchi S, Hasue M et al (1998) Pathoanatomic mechanisms of degenerative spondylolisthesis. A radiographic study. Spine 23:1447–1451

    Article  PubMed  CAS  Google Scholar 

  5. Kalichman L, Hunter DJ, Kim DH et al (2009) Association between disc degeneration and degenerative spondylolisthesis? Pilot study. J Back Musculoskelet Rehabil 22:21–25

    PubMed  Google Scholar 

  6. Varlotta GP, Lefkowitz TR, Schweitzer M et al (2011) The lumbar facet joint: a review of current knowledge: part 1: anatomy, biomechanics, and grading. Skeletal Radiol 40:13–23

    Article  PubMed  Google Scholar 

  7. Chen IR, Wei TS (2009) Disc height and lumbar index as independent predictors of degenerative spondylolisthesis in middle-aged women with low back pain. Spine 34:1402–1409

    Article  PubMed  Google Scholar 

  8. Luk KD, Chow DH, Holmes A (2003) Vertical instability in spondylolisthesis: a traction radiographic assessment technique and the principle of management. Spine 28:819–827

    PubMed  Google Scholar 

  9. Hong SW, Lee HY, Kim KH et al (2010) Interspinous ligamentoplasty in the treatment of degenerative spondylolisthesis: midterm clinical results. J Neurosurg Spine 13:27–35

    Article  PubMed  Google Scholar 

  10. Cho BY, Murovic JA, Park J (2009) Imaging correlation of the degree of degenerative L4–5 spondylolisthesis with the corresponding amount of facet fluid. J Neurosurg Spine 11:614–619

    Article  PubMed  Google Scholar 

  11. Pearcy M, Shepherd J (1985) Is there instability in spondylolisthesis? Spine 10:175–177

    Article  PubMed  CAS  Google Scholar 

  12. Takayanagi K, Takahashi K, Yamagata M et al (2001) Using cineradiography for continuous dynamic-motion analysis of the lumbar spine. Spine 26:1858–1865

    Article  PubMed  CAS  Google Scholar 

  13. Okawa A, Shinomiya K, Komori H et al (1998) Dynamic motion study of the whole lumbar spine by videofluoroscopy. Spine 23:1743–1749

    Article  PubMed  CAS  Google Scholar 

  14. McGregor AH, Anderton L, Gedroyc WM et al (2002) The use of interventional open MRI to assess the kinematics of the lumbar spine in patients with spondylolisthesis. Spine 27:1582–1586

    Article  PubMed  Google Scholar 

  15. Huang KY, Lin RM, Lee YL et al (2009) Factors affecting disability and physical function in degenerative lumbar spondylolisthesis of L4–5: evaluation with axially loaded MRI. Eur Spine J 18:1851–1857

    Article  PubMed  Google Scholar 

  16. Li G, Wang S, Passias P et al (2009) Segmental in vivo vertebral motion during functional human lumbar spine activities. Eur Spine J 18:1013–1021

    Article  PubMed  Google Scholar 

  17. Xia Q, Wang S, Kozanek M et al (2010) In vivo motion characteristics of lumbar vertebrae in sagittal and transverse planes. J Biomech 43:1905–1909

    Article  PubMed  Google Scholar 

  18. Wang S, Passias P, Li G, Wood K (2008) Measurement of vertebral kinematics using noninvasive image matching method-validation and application. Spine 33:E355–E361

    Article  PubMed  Google Scholar 

  19. Pfirrmann CW, Metzdorf A, Elfering A et al (2006) Effect of aging and degeneration on disc volume and shape: a quantitative study in asymptomatic volunteers. J Orthop Res 24:1086–1094

    Article  PubMed  Google Scholar 

  20. Vogt MT, Rubin DA, Palermo L et al (2003) Lumbar spine listhesis in older African American women. Spine J 3:255–261

    Article  PubMed  Google Scholar 

  21. Bolesta MJ, Bohlman HH (1989) Degenerative spondylolisthesis. Instr Course Lect 38:157–165

    PubMed  CAS  Google Scholar 

  22. Fujiwara A, Tamai K, An HS et al (2000) The relationship between disc degeneration, facet joint osteoarthritis, and stability of the degenerative lumbar spine. J Spinal Disord 13:444–450

    Article  PubMed  CAS  Google Scholar 

  23. Chagnon A, Aubin CE, Villemure I (2010) Biomechanical influence of disk properties on the load transfer of healthy and degenerated disks using a poroelastic finite element model. J Biomech Eng 132:111006

    Article  PubMed  Google Scholar 

  24. Dai L, Jia L (1996) Role of facet asymmetry in lumbar spine disorders. Acta Orthop Belg 62:90–93

    PubMed  CAS  Google Scholar 

  25. Toyone T, Ozawa T, Kamikawa K et al (2009) Facet joint orientation difference between cephalad and caudad portions: a possible cause of degenerative spondylolisthesis. Spine 34:2259–2262

    Article  PubMed  Google Scholar 

  26. Ramsbacher J, Theallier-Janko A, Stoltenburg-Didinger G et al (2001) Ultrastructural changes in paravertebral muscles associated with degenerative spondylolisthesis. Spine 26:2180–2185

    Article  PubMed  CAS  Google Scholar 

  27. Alqarni AM, Schneiders AG, Hendrick PA (2011) Clinical tests to diagnose lumbar segmental instability: a systematic review. J Orthop Sports Phys Ther 41:130–140

    PubMed  Google Scholar 

  28. Hasegewa K, Kitahara K, Hara T, Takano K, Shimoda H (2009) Biomechanical evaluation of segmental instability in degenerative lumbar spondylolisthesis. Eur Spine J 18(4):465–470

    Article  PubMed  Google Scholar 

  29. Kirkaldy-Willis WH, Farfan HF (1982) Instability of the lumbar spine. Clin Orthop Relat Res 165:110–123

    PubMed  Google Scholar 

  30. Nizard RS, Wybier M, Laredo JD (2001) Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis. Radiol Clin North Am 39:55–71 (v–vi)

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by NIH (R21AR057989) and China scholarship council.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Bioengineering Lab, Department of Orthopaedic Surgery, Massachussets General Hospital/Harvard Medical School, 55 Fruit St., GRJ 1215, Boston, MA, 02114, USA

    Jun Miao, Shaobai Wang, Zongmiao Wan, Won Man Park, Kirkham Wood & Guoan Li

  2. Department of Spinal Surgery, Tianjin Hospital, Tianjin, China

    Jun Miao & Qun Xia

  3. Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA

    Shaobai Wang

  4. Second Xiangya Hospital of Central South University, Changsha, China

    Zongmiao Wan

  5. Department of Mechanical Engineering, Kyung Hee University, Yongin, Korea

    Won Man Park

Authors
  1. Jun Miao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shaobai Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zongmiao Wan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Won Man Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Qun Xia
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kirkham Wood
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Guoan Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Guoan Li.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Miao, J., Wang, S., Wan, Z. et al. Motion characteristics of the vertebral segments with lumbar degenerative spondylolisthesis in elderly patients. Eur Spine J 22, 425–431 (2013). https://doi.org/10.1007/s00586-012-2428-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-012-2428-3

Keywords

Search

Navigation