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Related Experiment Videos

The Unstable Spine: A Surgeon's Perspective.

Scott A Vincent1, Paul A Anderson1

  • 1Department of Orthopedic Surgery & Rehabilitation, University of Nebraska Medical Center, Omaha, NE.

Seminars in Ultrasound, CT, and MR
|December 12, 2018
PubMed
Summary

Spinal instability is a complex condition requiring careful evaluation of pathology, imaging, and clinical exams. Determining spinal stability is crucial for guiding treatment decisions, whether surgical or non-surgical.

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Area of Science:

  • Spine Surgery
  • Orthopedics
  • Radiology

Background:

  • Spinal instability is a spectrum of conditions arising from various pathologies, including trauma, tumors, infections, and degeneration.
  • Accurate assessment of spinal stability is critical for treatment planning, distinguishing between operative and non-operative management.

Purpose of the Study:

  • To outline the multifaceted approach to evaluating spinal instability.
  • To highlight the roles of different diagnostic modalities and clinical examination in determining spinal stability.

Main Methods:

  • Review of imaging modalities: Computed Tomography (CT) for trauma, Magnetic Resonance Imaging (MRI) for ligamentous injury, infection, and neoplasm.
  • Emphasis on upright radiographs to assess spinal response to gravity and weight-bearing.

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  • Integration of thorough clinical examination findings, including neurological deficits.

    • Main Results:

    • No single classification system perfectly addresses all spinal instability cases.
    • Neurological deficits strongly suggest spinal instability, necessitating precautions.
    • Certain conditions like ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis increase instability risk.

    Conclusions:

    • Determining spinal stability requires a comprehensive, individualized approach.
    • Combining clinical assessment with imaging data, including upright radiographs, is essential for accurate diagnosis and treatment planning.