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Measurement of sagittal translation and sagittal angulation. Sagittal translation (%): The length between D and E/the length between C and E ×100, Sagittal angulation (°): θ is angle between AB line and CE line, A: Anterior margin of lower endplate of superior vertebra, B: Posterior margin of lower endplate of superior vertebra, C: Anterior margin of upper endplate of inferior vertebra, D: Crossing point between CE line and the perpendicular line to CE line from B E: Posterior margin of upper endplate of inferior vertebra.
Source publication
Retrospective chart review.
To assess whether spontaneous reduction of spondylolisthesis, as seen on magnetic resonance imaging (MRI), is related to the degree of segmental instability and low back pain.
The flexion-extension radiographs obtained in the sagittal plane are frequently used when segmental instability of spondylolisthesis is evaluated....
Context in source publication
Context 1
... the angle between the lower end plate of the upper ver- tebral body and the upper end plate of the lower vertebral body (Fig. 2). The segmental instability was classified ac- cording to Wiltse's criteria [8]. Unstable translation and un- stable angulation were defined as the differences regarding the percentages of sagittal translations and the degrees of the sagittal angulations between the flexion and extension ra- diographs in patients with segmental ...Similar publications
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Citations
... Preoperative lateral lumbar, lumbar hyper exion and hyperextension radiographs, and third day postoperative lateral lumbar radiographs were imported into the Surgimap ( Version: 2.2.9.8) software for the measurement of the following indicators: 1. Translation Distances (TD) [7], [8] : de ned as that the distance between Intersection of a vertical line drawn from the inferior posterior angle of a slipped vertebral body segment relative to the endplate of the inferior vertebral body segment and the superior posterior angle of the inferior vertebral body; 2. Segment angle(SA): de ned as the angle formed by the Lower endplate line of the vertebral body of a spondylolisthetic segment and the upper endplate line of the lower vertebral body of the same segment; 3. Slip rate [9], [10] (SR): de ned as the percentage of slip distance to the width of the sagittal plane of the inferior vertebral body; 4. Slip distance correction = preoperative slip distance-postoperative slip distance; 5. Segment angle correction = preoperative segment angle-postoperative segment angle; 6. Correction of slippage rate = preoperative slippage ratepostoperative slippage rate. The schematic diagram is shown in Figure 1. ...
Background
The aim of this study is to explore the use of preoperative imaging stability studies of adult lumbar spondylolisthesis and it's effects on intraoperative correction, postoperative observation, and clinical efficacy.
Methods
We retrospectively analyzed a total of 104 patients diagnosed with lumbar spondylolisthesis who underwent Posterior lumbar interbody fusion surgery between 2011 and 2014. The qualified patients were divided into two groups; group A (study/unstable group: 52 cases) and group B (control/stable group: 52 cases). Group A was further divided into group A1 (slip instability: 27 cases) and group A2 (angular instability: 25 cases). The preoperative lumbar sagittal plane translation distances and segmental angle of the preoperative lateral X-rays, hyperflexion X-rays, and hyperextension X-rays were measured and compared with their third-day postoperative lateral X-ray, and slip rate. The occurrences of intraoperative or postoperative complications, one-month postoperative follow-up data, including JOA, and VAS scores were access to evaluate the clinical efficacy of the treatment.
Results
Satisfactory postoperative radiographic correction was recorded in all groups. Better correction and correction was observed in group A1 patients and group B patients who used puller screws compared to those who used normal screws (P < 0.05). However, patients in group A2 who used normal pedicle screws had similar correction as those who used puller screws. The preoperative VAS scores showed that low back and lower extremity pain were higher in A1 and A2 groups compared to group B. However, they were lower one month postoperative. The preoperative JOA scores for the unstable groups (group A1 and A2) were lower than their stable counterpart but higher during the first month postoperative. Our analysis of postoperative complications also revealed no statistically significant difference between groups A1 and B, and groups A2, and B.
Conclusions
Preoperative imaging stability for adult lumbar spondylolisthesis does not affect intraoperative correction. The use of puller pedicle screws in patients with unstable or stable segmental slippage could achieve better correction and correction than with normal pedicle screws. The preoperative symptoms of patients with unstable segments were worse than their stable counterparts; however, their postoperative recovery was quicker in the first month postoperative.
... The approach for measurements acquisition was adopted after review of available literature. 1,3,6,[8][9][10] It was approved by a board certified radiologist in Diagnostic Radiology and Neuroradiology with more than 10 yr of experience in clinical practice (T.K.). We measured the forward and backward displacement for anterolisthesis and retrolisthesis, respectively, and the superior endplate diameter (SEPD) of the caudal segment of slippage, for both X-rays and MRI. ...
BACKGROUND
Degenerative spondylolisthesis is the displacement of one vertebral body over the adjacent one. While standing and flexion-extension X-rays are preferred for determining listhesis, magnetic resonance imaging (MRI) is often utilized to assess the compression of nerve root or spinal cord.
OBJECTIVE
To investigate the difference in radiographic measurements of spondylolisthesis between X-rays and MRI.
METHODS
We retrospectively reviewed the records and radiographic images of patients with a confirmed diagnosis of spondylolisthesis undergoing operation in 2016. Primary variable of interest was the degree of slippage as per the Meyerding method. Agreement between the 2 reviewers was assessed using the 2-way intraclass correlation coefficient (ICC) for slippage percentage and Cohen's Kappa for grade. Agreement of Meyerding grade between the 2 imaging techniques was assessed using Cohen's Kappa, while the slip percentage measured for each technique was compared using a Bland-Altman (BA) plot, mean difference (MD), and 1-way ICC.
RESULTS
A total of 255 cases were analyzed. ICC between the 2 reviewers was found to be 0.75 (95% confidence interval [CI] = 0.64-0.83, P < .001) for X-ray and 0.76 (95% CI = 0.66-0.83, P < .001) for MRI. Agreement between X-ray and MRI for grading of spondylolisthesis was found to be poor (kappa = 0.32, P < .001). BA plot between X-ray and MRI measurements revealed an MD of 4.4% (95% limits of agreement: –10.3% to 19.3%) with 5.16% observations outside the limits of agreement and 1-way ICC of 0.35 showing poor agreement.
Conclusion
Our results demonstrate the discrepancy of spondylolisthesis grade measurements between weight-bearing X-ray and nonweight-bearing MRI. Careful evaluation of both imaging technique is warranted to determine the final severity of pathology and tailoring of management plan.
... Other radiological modalities such as magnetic resonance imaging and computed tomography have also been used to aid the diagnosis of instability [1]. In 2012, Chung and co-authors described the phenomenon of spontaneous reduction of the listhetic segment on supine magnetic resonance imaging when compared to a standing lateral lumbar radiograph [16]. This was theorized to be due to the elimination of physiological loading in the supine position compared to the standing position. ...
... This was theorized to be due to the elimination of physiological loading in the supine position compared to the standing position. In a retrospective review of 137 patients, they found the degree of spontaneous reduction to be closely related to instability [16]. We applied the Posner criteria to the spontaneous reduction phenomenon as described by Chung to find out the criterion sensitivity. ...
... Magnetic resonance imaging often prove useful in the assessment of a patient with suspected spinal pathology presenting with persistent or recurrent lower back and/or leg pain refractory to conservative management. It is generally accepted to be the most accurate imaging method for diagnosing degenerative changes of the spine [1] and is often used to identify central or foraminal stenosis [16]. It is also a favoured imaging modality due to its high contrast and spatial resolution and lack of ionizing radiation [23]. ...
Objective: Dynamic radiographs are widely used to assess radiological spinal instability. The authors aim to compare the sensitivity of dynamic radiographs versus spontaneous reduction seen on magnetic resonance imaging when compared to a standing lateral radiograph in diagnosing instability.Materials and Methods: This study is a retrospective review of 75 patients from a single center with suspected clinical lumbar spinal instability presenting with back and/or leg pain and had undergone a magnetic resonance imaging of their lumbosacral spine as well as a lumbar radiograph series. The authors compared the criterion sensitivity (in accordance to Posner criteria) of dynamic radiographs versus magnetic resonance imaging. Pearson's chi-square test was used to determine statistical significance.Results: The Posner criteria was satisfied in 45/75 patients (60%) using dynamic radiographs as compared to 32/75 patients (42.6%) when using spontaneous reduction seen on magnetic resonance imaging. This was statistically significant (p<0.01). However, we noted that 29/45 (64.4%) patients with instability diagnosed on dynamic radiographs also had it diagnosed on spontaneous reduction.Conclusion: Posner criteria when applied to spontaneous reduction seen on magnetic resonance imaging has a specificity of 90% and positive predictive value of 90.63%, assuming that satisfaction of Posner criteria on dynamic radiographs indicates true instability. The authors advocate the use of Posner criteria applied to spontaneous reduction to assess for spinal instability. Failure to satisfy the Posner criteria on spontaneous reduction should then prompt the use of a more sensitive modality such as dynamic radiographs.
... La espondilolistesis se defi ne radiográfi camente como una rotación sagital > 10 o y una traslación sagital > 4 mm. 31,32,33 La clasifi cación de Meyerding se utiliza para estadifi car la espondilolistesis. Grado I 25% de deslizamiento, grado II 25-50% de deslizamiento, grado III 50% de deslizamiento y grado IV 100% de deslizamiento o mayor. ...
Spondylolisthesis is the sliding of a vertebral body with respect to the adjacent one. According to the degree of slippage it is classified into 4 Meyerding grades. Patients with spondylolisthesis who underwent surgery with lumbar instrumentation were included. They were divided into two groups based on their body mass index: obese and non-obese. The functional capacity Oswestry score was calculated preoperatively and at one year, and it was correlated with the BMI. A total of 46 patients, 26 females and 20 males, were included, from 2010 to 2013, all of them with a diagnosis of degenerative spondylolisthesis with lumbar stenosis. Mean age was 58.9 years. The mean preoperative Oswestry disability index was 41% in non-obese patients and 47% in obese patients. At the one-year postoperative assessment the disability index was 12.30% in non-obese patients and 23.84% in obese patients. Non-obese patients had a more favorable clinical course compared to the group of obese patients.
... La espondilolistesis se defi ne radiográfi camente como una rotación sagital > 10 o y una traslación sagital > 4 mm. 31,32,33 La clasifi cación de Meyerding se utiliza para estadifi car la espondilolistesis. Grado I 25% de deslizamiento, grado II 25-50% de deslizamiento, grado III 50% de deslizamiento y grado IV 100% de deslizamiento o mayor. ...
Spondylolisthesis is the sliding of a vertebral body with respect to the adjacent one. According to the degree of slippage it is classified into 4 Meyerding grades. Patients with spondylolisthesis who underwent surgery with lumbar instrumentation were included. They were divided into two groups based on their body mass index: obese and non-obese. The functional capacity Oswestry score was calculated preoperatively and at one year, and it was correlated with the BMI. A total of 46 patients, 26 females and 20 males, were included, from 2010 to 2013, all of them with a diagnosis of degenerative spondylolisthesis with lumbar stenosis. Mean age was 58.9 years. The mean preoperative Oswestry disability index was 41% in non-obese patients and 47% in obese patients. At the one-year postoperative assessment the disability index was 12.30% in non-obese patients and 23.84% in obese patients. Non-obese patients had a more favorable clinical course compared to the group of obese patients.
