Sagittal alignment and segmental range of motion after total disc replacement of the lumbar spine

被引:15
作者
Cakir, B [1 ]
Schmidt, R [1 ]
Huch, K [1 ]
Puhl, W [1 ]
Richter, M [1 ]
机构
[1] Univ Ulm, Rehabil Krankenhaus Ulm, Orthopad Klin,Orthopad Abt, Querschnittgelahmtenzentrum, D-89081 Ulm, Germany
来源
ZEITSCHRIFT FUR ORTHOPADIE UND IHRE GRENZGEBIETE | 2004年 / 142卷 / 02期
关键词
total disc replacement; range of motion; degenerative disc disease;
D O I
10.1055/s-2004-816275
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Aim: To evaluate changes in static and dynamic values, X-rays of patients who underwent total disc replacement for degenerative disc disease were analyzed. Method: An analysis of pre- and postoperative lateral X-rays in 22 patients with 24 total disc replacements (Prodics(R), Spine Solutions) was performed. The total lumbar lordosis, the segmental lordosis angle, the disc height and the range of motion in the operated level were measured. Results: Postoperatively a significant increase was observed for the following parameters: the anterior (pre: 9.0 +/- 3.4 mm; post: 16.7 +/- 2.4 mm; p < 0.001) and posterior (pre: 4.4 +/- 1.3 mm; post: 8.8 +/- 1.3 mm; p < 0.001) disc height and the segmental lordosis angle (pre: 20degrees +/- 7.2degrees; post: 27.7degrees +/- 7.4degrees; p < 0.001). Statistically no significant changes could be observed postoperatively for the total lumbar lordosis (pre: 56.2 degrees +/- 10.7 degrees; post: 58.6 degrees +/- 9.3 degrees; p=0.196) and the range of motion (pre: 5.0 degrees +/- 4.0 degrees; post: 5.9 degrees +/- 3.5 degrees; p = 0.293). Conclusion: Total disc replacement for degenerative disc disease of the lumbar spine with the current concept does not alter the range of motion but significantly increases the disc height. The significant increase in segmental lordosis without a change in the total lumbar lordosis accounts for a change in lordosis in adjacent segments.
引用
收藏
页码:159 / 165
页数:7
相关论文
共 34 条
  • [1] Akamura T., Kawahara N., Yoon T., Minamide A., Kim K.S., Tomita K., Hutton W.C., Adjacent segment motion after a simulated lumbar fusion in different sagittal alignments, Spine, 28, pp. 1560-1566, (2003)
  • [2] Bertagnoli R., Kumar S., Indications for full prosthetic disc arthroplasty: A correlation of clinical outcome against a variety of indications, Eur Spine J, 11, pp. 131-136, (2002)
  • [3] Dabbs V.M., Dabbs L.G., Correlation between disc height narrowing and low-back pain, Spine, 15, pp. 1366-1369, (1990)
  • [4] De Kleuver M., Oner F.C., Jacobs W.C., Total disc replacement for chronic low back pain: Background and a systematic review of the literature, Eur Spine J, 12, pp. 108-116, (2003)
  • [5] Dvorak J., Panjabi M.M., Chang D.G., Theiler R., Grob D., Functional radiographic diagnosis of the lumbar spine. Flexion-extension and lateral bending, Spine, 16, pp. 562-571, (1991)
  • [6] Dvorak J., Panjabi M.M., Grob D., Novotny J.E., Antinnes J.A., Clinical Validation of Functional Flexion/Extension Radiographs of the Cervical Spine, Spine, 18, pp. 943-950, (1993)
  • [7] Gelb D.E., Lenke L.G., Bridwell K.H., Blanke K., McEnery K.W., An analysis of sagittal spinal alignment in 100 asymptomatic middle and older aged volunteers, Spine, 20, pp. 1351-1358, (1995)
  • [8] Gilad I., Nissan M., A Study of Vertebra and Disc Geometric Relations of the Human Lumbar and Cervical Spine, Spine, 11, pp. 154-157, (1986)
  • [9] Godde S., Ekkehard F., Dienst M., Kohn D., Influence of cage geometry on sagittal alignment in instrumented posterior lumbar interbody fusion, Spine, 28, pp. 1693-1699, (2003)
  • [10] Gregersen G.G., Lucas D.B., An in Vivo Study of the Axial Rotation of the Human Thoracolumbar Spine, J Bone Joint Surg [Am], 49, pp. 247-262, (1967)