Centrode Patterns and Segmental Instability in Degenerative Disc Disease

Gertzbein, Stanley D.; Seligman, J; Holtby, Richard; Chan, KH; Kapasouri, A; Tile, Marvin; Cruickshank, Bruce

doi:10.1097/00007632-198504000-00014

Cited by 140 publications

(49 citation statements)

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“…Testing showed that the position and shape of the IAR locus of the intact and implanted specimen is consistent with published data [19][20][21][22][23][24]. The motion-tracking camera recorded the position of the markers used to generate the IAR locus in 2D space only, and therefore movement of the markers perpendicularly to the plane of measurement were not captured.…”

Section: Discussionsupporting

confidence: 78%

An in vitro biomechanical comparison of Cadisc™-L with natural lumbar discs in axial compression and sagittal flexion

McNally

Naylor

Johnson³

2012

Eur Spine J

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Introduction The elastomeric, monobloc disc prosthesis (Cadisc TM -L, Ranier Technology, Cambridge, UK) aims to preserve biomechanics of an implanted spinal motion segment. Study design This study presents the findings of an in vitro investigation on the effect of implantation of Cadisc TM -L. Compressive stiffness, flexion stiffness at 10, 20, 30 and 40 Nm and the instant-axis-of-rotation (IAR) loci are compared before and after implantation of a MC-10 mm-6°Cadisc TM -L. MethodsFresh frozen human monosegmental lumbar spines (n = 8) were prepared, potted and tested in an environmentally controlled chamber to simulate in vivo conditions. Specimens were preconditioned by loading to 500 N for 30 min. Compressive stiffness of the specimen was determined by applying pure compression of 1 kN at 250 N/s via a loading roller positioned at the central loading axis (CLA). The roller was then offset 12.5 mm anterior of the CLA and the loading regime repeated to test specimens in flexion. Bending moments were calculated from the applied load and corresponding flexion angle. The IAR locus was tracked by a motion-tracking camera. Results ConclusionsImplantation of Cadisc TM -L caused a reduction in axial stiffness, but maintained disc height and flexion stiffness. IAR loci remained mobile without large displacement of the centroid from the intact spine position.

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Section: Discussionsupporting

confidence: 78%

An in vitro biomechanical comparison of Cadisc™-L with natural lumbar discs in axial compression and sagittal flexion

McNally

Naylor

Johnson³

2012

Eur Spine J

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“…In contrast to some previous studies, the image intensifier of current study was not fixed while subjects wore a lead harness which enabled us to measure intersegmental linear and angular displacements at all vertebral levels within whole range of motion and had better quality of digital images. Furthermore, we used ICR and PICR variables to identify the quality of motion and assessed neuromuscular control of motion segments during lumbar movements [21].…”

Section: Discussionmentioning

confidence: 99%

“…There may be other factors as well, such as neuromuscular control of spinal movement and aberrant or abnormal midrange motion characteristics. Pathway of instantaneous center of rotation (PICR) may be affected in presence of segmental instability [20,21] which has not been considered in vivo for LSI patients. Therefore, it is imperative that for assessing some disorders, such as LSI both quantitative and qualitative characteristics of movement should be considered.…”

Section: Introductionmentioning

confidence: 99%

Kinematic analysis of dynamic lumbar motion in patients with lumbar segmental instability using digital videofluoroscopy

et al. 2009

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The study design is a prospective, case-control. The aim of this study was to develop a reliable measurement technique for the assessment of lumbar spine kinematics using digital video fluoroscopy in a group of patients with low back pain (LBP) and a control group. Lumbar segmental instability (LSI) is one subgroup of nonspecific LBP the diagnosis of which has not been clarified. The diagnosis of LSI has traditionally relied on the use of lateral functional (flexion-extension) radiographs but use of this method has proven unsatisfactory. Fifteen patients with chronic low back pain suspected to have LSI and 15 matched healthy subjects were recruited. Pulsed digital videofluoroscopy was used to investigate kinematics of lumbar motion segments during flexion and extension movements in vivo. Intersegmental linear translation and angular displacement, and pathway of instantaneous center of rotation (PICR) were calculated for each lumbar motion segment. Movement pattern of lumbar spine between two groups and during the full sagittal plane range of motion were analyzed using ANOVA with repeated measures design. Intersegmental linear translation was significantly higher in patients during both flexion and extension movements at L5-S1 segment (p \ 0.05). Arc length of PICR was significantly higher in patients for L1-L2 and L5-S1 motion segments during extension movement (p \ 0.05). This study determined some kinematic differences between two groups during the full range of lumbar spine. Devices, such as digital videofluoroscopy can assist in identifying better criteria for diagnosis of LSI in otherwise nonspecific low back pain patients in hope of providing more specific treatment.

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“…Flexion and extension radiographs could be used to identify and quantify increased end-range motion at lumbar spinal segments. Gertzbein et al 8 provided evidence that in mildly and moderately degenerated spinal segments, motion was not thought to be excessive but rather erratic. Only 33% of cadaveric spines with mild and moderate degeneration spinal segments demonstrated excessive range of motion based on flexion and extension radiographs.…”

Section: Historical Perspectivementioning

confidence: 99%

Lumbar instability: an evolving and challenging concept

Beazell

Mullins

Grindstaff

2010

Journal of Manual & Manipulative Therapy

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Identification and management of chronic lumbar spine instability is a clinical challenge for manual physical therapists. Chronic lumbar instability is presented as a term that can encompass two types of lumbar instability: mechanical (radiographic) and functional (clinical) instability (FLI). The components of mechanical and FLI are presented relative to the development of a physical therapy diagnosis and management. The purpose of this paper is to review the historical framework of chronic lumbar spine instability from a physical therapy perspective and to summarize current research relative to clinical diagnosis in physical therapy.

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Centrode Patterns and Segmental Instability in Degenerative Disc Disease

Cited by 140 publications

References 0 publications

An in vitro biomechanical comparison of Cadisc™-L with natural lumbar discs in axial compression and sagittal flexion

An in vitro biomechanical comparison of Cadisc™-L with natural lumbar discs in axial compression and sagittal flexion

Kinematic analysis of dynamic lumbar motion in patients with lumbar segmental instability using digital videofluoroscopy

Lumbar instability: an evolving and challenging concept

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