Grade three disc degeneration is a critical stage for anterior spondylolisthesis in lumbar spine

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• 作者：Tetsuhiro Iguchi (1)
  Kotaro Nishida (3)
  Takuma Ozaki (2)
  Atsushi Kitagawa (2)
  Nobuhiro Tsumura (2)
  Kenichiro Kakutani (3)
  Takashi Yurube (3)
  Ryosuke Kuroda (3)
  
• 关键词：Lumbar spine ; Disc degeneration ; Instability ; Spondylolisthesis ; MRI
• 刊名：European Spine Journal
• 出版年：2012
• 出版时间：November 2012
• 年：2012
• 卷：21
• 期：11
• 页码：2134-2139
• 全文大小：265KB
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• 作者单位：Tetsuhiro Iguchi (1)
  Kotaro Nishida (3)
  Takuma Ozaki (2)
  Atsushi Kitagawa (2)
  Nobuhiro Tsumura (2)
  Kenichiro Kakutani (3)
  Takashi Yurube (3)
  Ryosuke Kuroda (3)
  
  1. Department of Rehabilitation Science, Kobe University Graduate School of Medicine in Hyogo Rehabilitation Center, 1070 Akebono-cho, Nishi-ku, Kobe, 651-2181, Japan
  3. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, 650-0017, Japan
  2. Department of Orthopaedic Surgery, Hyogo Rehabilitation Center Hospital, Kobe, 651-2181, Japan
  
• ISSN：1432-0932

文摘

Introduction Little is known about when and how progressive spondylolisthesis occurs. In this report segmental motion related to age and disc degeneration at L4/5 disc was investigated. Materials and methods 637 patients with low back and/or leg pain underwent radiologic and MRI examinations simultaneously. Because 190 patients with conditions which might impede accurate measurement were excluded, 447 patients, comprising 268 men and 179 women, were included; age range, was 10-6 (mean: 53) years. Three radiologic parameters slip in neutral position (mm), sagittal translation (mm), and segmental angulation (degrees) were examined at the L4/5 segment. On T2-weighted MRI, severity of disc degeneration at L4/5 was classified by Pfirrmann’s criteria, grade 1-5. Results Results showed stage of disc degeneration that progressed according to aging with significant differences except for between grades 4 and 5. Amount of anterior slip was small among grades 1 to 3; however, it greatly increased between grades 3 and 4 and between grades 4 and 5, suggesting that grade 3 disc degeneration has a potential risk of future progression of anterior slip. This finding may also suggest that once significant slip occurs, it will progress to the final grade. Furthermore, the grade 3 degeneration group exhibited large amounts of motion in both angulation and translation, suggesting it was the most unstable group. Conclusion Our results with radiography and MRI indicate that grade 3 disc degeneration is a critical stage for the progression of lumbar spondylolisthesis at L4/5 segment.