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Image-Based Markers Predict Dynamic Instability in Lumbar Degenerative Spondylolisthesis.
William Slikker Iii1,2,3, Alejandro A Espinoza Orías1,2, Grant D Shifflett1,2
1Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
Neurospine
|April 7, 2020
Summary
Preserved disc height (DH) in degenerative spondylolisthesis (DS) may predict dynamic instability, indicating potential slip progression. Conversely, disc degeneration and spondylosis might act as restabilization mechanisms, reducing future slip risk.
Area of Science:
- Spine surgery
- Radiology
- Orthopedics
Background:
- Degenerative spondylolisthesis (DS) is a common spinal condition.
- Dynamic instability is a key factor in DS progression and patient symptoms.
- Identifying predictors of dynamic instability is crucial for treatment planning.
Purpose of the Study:
- To identify radiographic markers predicting dynamic instability in degenerative spondylolisthesis (DS).
- To explore the relationship between disc height (DH), disc degeneration, spondylosis, and dynamic instability in DS patients.
Main Methods:
- Retrospective review of 125 patients with L4-L5 DS undergoing decompression and fusion.
- Analysis of lumbar spine radiographs (neutral, flexion, extension) and MRI scans.
- Correlation of radiographic parameters (DH, motion, spondylosis) and MRI findings with dynamic instability status.
Main Results:
- Thirty-one percent of patients exhibited dynamic instability.
- Preserved DH correlated significantly with dynamic instability (p < 0.05).
- Increased spondylosis and disc degeneration were inversely related to dynamic instability, suggesting restabilization.
Conclusions:
- Preserved DH in DS patients may indicate a higher risk of slip progression.
- Disc degeneration and spondylosis may act as natural restabilization mechanisms in DS.
- Radiographic parameters can help predict dynamic instability in DS, aiding clinical decision-making.
