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Spondylolisthesis with postural slip reduction shows different motion patterns with video-fluoroscopic analysis
Kazuyuki Otani1, Atsushi Okawa, Kenichi Shinomiya
1Department of Orthopaedic and Spinal Surgery, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Summary
Lumbar spondylolisthesis motion differs between standing and decubitus positions, especially with significant slip reduction. Increased motion at the slip level and adjacent segments suggests instability, recommending stable fusion techniques.
Area of Science:
- Orthopedics
- Radiology
- Biomechanics
Background:
- Lumbar spondylolisthesis involves vertebral slippage, often causing pain and instability.
- Understanding motion changes in different positions is crucial for surgical planning.
Purpose of the Study:
- To compare lumbar spondylolisthesis motion between standing and decubitus positions.
- To identify radiological parameters associated with segmental instability.
Main Methods:
- Video-fluoroscopy recorded lumbar sagittal motion in 5 volunteers and 14 patients.
- Motion patterns were analyzed in standing and decubitus positions.
- Patients were subgrouped by postural slip reduction.
Main Results:
- No significant motion differences in volunteers or small slip reduction groups.
- In the large slip reduction group, increased range of motion (ROM) at the slip level and shifts in motion occurred in the decubitus position.
- Anterior slip reduction in the supine position correlated with increased disc angle and height, suggesting anterior column deficiency.
Conclusions:
- Lumbar spondylolisthesis exhibits altered motion patterns in the decubitus position, particularly with significant slip reduction.
- These changes indicate potential anterior column deficiency and soft tissue laxity.
- A biomechanically stable fusion technique is recommended for surgical management.