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Related Experiment Videos

Intervertebral mobility in the progressive degenerative process. A radiostereometric analysis.

Paul Axelsson1, Bjarki S Karlsson

  • 1Department of Orthopedics, Lund University Hospital, 221 85 Lund, Sweden. paul.axelsson@skane.se.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|May 20, 2004
PubMed
Summary

Degenerative disc disease shows changing mobility. Stabilization begins when disc height reduces by 50%, but individual differences mean instability can persist even with significant degeneration.

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Area of Science:

  • Orthopedics
  • Biomedical Engineering
  • Radiology

Background:

  • The three-stage hypothesis of spinal degeneration posits temporary dysfunction, segmental instability with deformity, and osteoligamentary repair-induced stabilization.
  • Understanding intervertebral mobility changes is crucial for diagnosing and managing low back pain.

Purpose of the Study:

  • To test the three-stage hypothesis of spinal degeneration by assessing intervertebral mobility in relation to disc degeneration.
  • To evaluate the relationship between disc height loss and segmental instability in the lumbar spine.

Main Methods:

  • Radiostereometric analysis (RSA) was used to measure intervertebral mobility (vertical and sagittal translation) in 18 adult patients with low back pain and degenerative disc findings.
  • Lumbar disc segments were categorized into four grades (IA-IV) based on disc height and dehydration.

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Main Results:

  • Vertical mobility increased slightly and non-significantly with initial disc height loss (grades IB and II).
  • A significant reduction in vertical mobility was observed when disc height decreased by at least 50% (grade III).
  • Sagittal translation showed non-significant changes across degeneration grades, with a reduction in grade III.

Conclusions:

  • Intervertebral mobility changes during disc degeneration, with stabilization commencing around 50% disc height reduction.
  • Segmental mobility status is not solely predictable from radiographic disc degeneration stage due to pronounced inter-individual variability.
  • Instability may persist even with significant disc height reduction (grade III), and a preceding instability stage with deformity was not confirmed in this study.