Mobility of the Lower Lumbar Spine After Posterolateral Fusion Determined by Roentgen Stereophotogrammetric Analysis

Johnsson, Ragnar; Selvik, Göran; Strömqvist, Björn; Sundén, G

doi:10.1097/00007632-199005000-00001

Cited by 82 publications

(51 citation statements)

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“…As an objective method to determine the in vivo stability of the fixed segments, RSA can be used. RSA has been proven to be a highly accurate method of determining the mobility between vertebrae [9]. The main drawbacks of the method are that it is expensive and time consuming, from surgery to the final analysis, which makes it unsuitable for studies of large patient series.…”

Section: Discussionmentioning

confidence: 99%

“…3 The placement of the tantalum markers Fig. 4 The roentgen stereophotogrammetric analysis (RSA) radiographic set-up Previous RSA studies have shown that the intervertebral mobility before and after uninstrumented posterolateral fusion can amount to several millimetres [2,10], and the healing speed is rather slow, sometimes exceeding 6 months [9]. Uninstrumented posterolateral fusion has a variable healing rate, but is a valid alternative for treating isthmic spondylolisthesis [1,6,15].…”

Section: Discussionmentioning

confidence: 99%

“…To enable RSA follow-up the outermost vertebrae included in the fusion had 0.8-mm tantalum markers inserted at standardized locations [9]: in the sacrum, in the spinous processes and in the transverse processes or the pedicles of the lumbar vertebrae (Fig. 3).…”

Section: Surgerymentioning

confidence: 99%

“…RSA was performed 4 weeks after surgery. This time interval was chosen with a view to achieving soft tissue healing and reduced pain, but not bony fusion healing [9], enabling the evaluation of the inherent stability of the implant.…”

Section: Roentgen Stereophotogrammetric Analysismentioning

confidence: 99%

“…The change between the three-dimensional positions of the markers in each vertebra, induced by positional change from This method has previously been determined accurate to 0.3, 0.6 and 0.7 mm, along the transverse, vertical and sagittal axes respectively [9]. Intervertebral translations induced by positional change from supine to standing were not considered significant unless exceeding these values.…”

Section: Roentgen Stereophotogrammetric Analysismentioning

confidence: 99%

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

Gunnarsson

Axelsson

Johnsson

et al. 2000

European Spine Journal

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IntroductionThere are many ways to fuse the lumbar spine, and indications vary, especially concerning degenerative disorders. The fact that indications vary and often have not been sufficiently validated must, however, not draw our interest from the technical aspects of the procedure, which ideally involves minimal trauma, has few complications and yields a high fusion rate.The abundance of implants on the market and techniques used today further emphasize a need to evaluate Abstract The aim of the study was to design a method for evaluating the stabilizing effect of different lumbar spine implants in vivo, and to apply this method to a comparison of plates versus rods in lumbar spine posterolateral fusion using transpedicular screw fixation. Fourteen patients, seven operated on with transpedicular plates and screws (VSP), and seven operated on with rods and screws (Diapason), matched according to number of levels fused, had tantalum markers inserted in the vertebrae at surgery, enabling roentgen stereophotogrammetric analysis (RSA). Mean patient age was 45 (range 33-56) years. In each group, two patients underwent fusion between L4 and L5, three between L5 and S1, and two from L4 to S1. In three patients, concomitant nerve root decompression was performed using a facet joint preserving technique. RSA was performed 4 weeks after surgery. This interval was chosen to allow enough time for soft tissue healing, but not fusion healing, to occur. RSA was performed in supine and standing position without any mobility provocation, in line

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Surgerymentioning

confidence: 99%

Section: Roentgen Stereophotogrammetric Analysismentioning

confidence: 99%

Section: Roentgen Stereophotogrammetric Analysismentioning

confidence: 99%

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

Gunnarsson

Axelsson

Johnsson

et al. 2000

European Spine Journal

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Application of image registration to measurement of intervertebral rotation in the lumbar spine

Rogers

Haughton

Arfanakis

et al. 2002

Magnetic Resonance in Med

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In this study, the precision and accuracy of a new method for measuring axial rotations of the lumbar vertebrae, which are thought to be increased in patients with degenerative spinal instability, were estimated. A standard image registration algorithm involving a user-selected center of rotation was adapted for this purpose. Accuracy was tested on a phantom containing a rotating lumbar vertebra. Calculated rotations were compared to the known values. Images were also obtained in subjects, using a tilting table that provided rotation between thorax and hips. For these measurements precision was estimated by varying the center of rotation. In the phantom the method had an accuracy of 0.2°. In the human subject measurements the precision was 0.60 -1.5°. The method measured rotations of lumbar vertebrae with sufficient accuracy and precision to detect clinically significant differences in patients with back pain.

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Posterolateral lumbar fusion using facet joint fixation with biodegradable rods: A pilot study

1997

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Roentgen stereophotogrammetric analysis (RSA) was used to assess whether there is a potential for biodegradable rods crossing the denuded facet joints to increase the stability and healing rate of lumbar posterolateral fusions. Eleven consecutive patients with lumbosacral disc/facet joint degeneration had a posterolateral fusion augmented with 2-or 3.2-mm biodegradable rods passing perpendicularly through the center of the denuded facet joints. The patients were followed-up with RSA in supine and erect positions monthly from the 2nd to the 6th postoperative month, and again 1 year postoperatively. All seven L5-S 1 fusions healed. Four cases were stable as defined by RSA within 3 months, two within 6 months, and one within 1 year. One L4-S 1 fusion could not be evaluated by RSA.None of the remaining three L4-S 1 fusions fully healed. In all three cases 1-to 3-mm intervertebral translations remained at 1 year. None of the 11 fusions showed any radiographic signs of osteolysis around the biodegradable rods. The promising results of this pilot study indicate that posterolateral L5-S 1 fusion augmented with transarticular biodegradable rods crossing the denuded facet joints may yield rapid intervertebral stabilization and a high healing rate without any adverse rod effects. This may be due to enhanced initial fusion stabilization and/or increased ossification induced by the rods.

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Mobility of the Lower Lumbar Spine After Posterolateral Fusion Determined by Roentgen Stereophotogrammetric Analysis

Cited by 82 publications

References 0 publications

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

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

Application of image registration to measurement of intervertebral rotation in the lumbar spine

Posterolateral lumbar fusion using facet joint fixation with biodegradable rods: A pilot study

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