A method to evaluate the in vivo behaviour of lumbar spine implants

Gunnarsson, Gunnar; Axelsson, Paul; Johnsson, Ragnar; Strömqvist, Björn

doi:10.1007/s005860000143

Cited by 18 publications

(10 citation statements)

References 16 publications

(15 reference statements)

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“…Since then, the method has been subjected to several updates (92,93). RSA has proved to be a precise quantifying method for evaluating micromotions between different structures and has been used in many orthopaedic fields such as prosthetic fixation (94), joint stability and kinematics (95), fracture stability (96), and spinal fusion stability (97,98), as well as to assess three-dimensional translatory and rotatory motion in the lumbar spine (99,100). This method requires the insertion of at least three radio-opaque tantalum markers in each vertebra to determine the geometric characteristics of the vertebral anatomy.…”

Section: Radiostereometric Analysis and Distortion-compensated Roentgmentioning

confidence: 99%

Lumbar Intervertebral Instability: A Review

Leone¹,

Guglielmi²,

et al. 2007

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Intervertebral instability of the lumbar spine is thought to be a possible pathomechanical mechanism underlying low back pain and sciatica and is often an important factor in determining surgical indication for spinal fusion and decompression. Instability of the lumbar spine, however, remains a controversial and poorly understood topic. At present, much controversy exists regarding the proper definition of the condition, the best diagnostic methods, and the most efficacious treatment approaches. Clinical presentation is not specific, and the relationship between radiologic evidence of instability and its symptoms is controversial. Because of its simplicity, low expense, and pervasive availability, functional flexion-extension radiography is the most thoroughly studied and the most widely used method in the imaging diagnosis of lumbar intervertebral instability. In this article, we provide an overview of the current concepts of vertebral instability, focusing on degenerative lumbar intervertebral instability, and review the different imaging modalities most indicated in diagnosing vertebral instability.

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Section: Radiostereometric Analysis and Distortion-compensated Roentgmentioning

confidence: 99%

Lumbar Intervertebral Instability: A Review

Leone¹,

Guglielmi²,

et al. 2007

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“…Recently, investigators have developed various non-invasive methods of recording the kinematics of the lumbar spine Gunnarsson et al, 2000;Kooi et al, 2004;Maigne et al, 2003;Powers et al, 2003;Rogers et al, 2002;Zheng et al, 2003). These methods are important research tools, but do not provide a clinical tool physicians can readily use with conventional radiographs.…”

Section: Introductionmentioning

confidence: 98%

Assessment of non-invasive intervertebral motion measurements in the lumbar spine

Zhao

Yang

Zhao

et al. 2005

Journal of Biomechanics

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“…Stereoradiogrammetric analysis (SRA) is an accurate 3D in vivo measurement technique for motion measurement [86,87] However, in this case the tantalum beads are placed in each of the vertebra of the segment of interest at surgery to track vertebra displacements. This makes the technique a bit less practical to use by a surgeon.…”

Section: In Vivo Kinematics-stereoradiogrammetric (Sr) Techniquementioning

confidence: 99%

Parameters that effect spine biomechanics following cervical disc replacement

et al. 2011

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Total disc replacement (TDR) is expected to provide a more physiologic alternative to fusion. However, long-term clinical data proving the efficacy of the implants is lacking. Limited clinical data suggest somewhat of a disagreement between the in vitro biomechanical studies and in vivo assessments. This conceptual paper presents the potential biomechanical challenges affecting the TDR that should be addressed with a hope to improve the clinical outcomes and our understanding of the devices. Appropriate literature and our own research findings comparing the biomechanics of different disc designs are presented to highlight the need for additional investigations. The biomechanical effects of various surgical procedures are analyzed, reiterating the importance of parameters like preserving uncinate processes, disc placement and its orientation within the cervical spine. Moreover, the need for a 360°dynamic system for disc recipients who may experience whiplash injuries is explored. Probabilistic studies as performed already in the lumbar spine may explore high risk combinations of different parameters and explain the differences between ''standard'' biomechanical investigations and clinical studies. Development of a patient specific optimized finite element model that takes muscle forces into consideration may help resolve the discrepancies between biomechanics of TDR and the clinical studies.Factors affecting long-term performance such as bone remodeling, subsidence, and wear are elaborated. In vivo assessment of segmental spine motion has been, and continues to be, a challenge. In general, clinical studies while reporting the data have placed lesser emphasis on kinematics following intervertebral disc replacements. Evaluation of in vivo kinematics following TDR to analyze the quality and quantity of motion using stereoradiogrammetric technique may be needed.

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A method to evaluate the in vivo behaviour of lumbar spine implants

Cited by 18 publications

References 16 publications

Lumbar Intervertebral Instability: A Review

Lumbar Intervertebral Instability: A Review

Assessment of non-invasive intervertebral motion measurements in the lumbar spine

Parameters that effect spine biomechanics following cervical disc replacement

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