caa a22 4500 445834110 CHVBK 20180317145325.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s00586-011-1793-7 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1793-7 Intimate relationship between instability and degenerative signs at L4/5 segment examined by flexion-extension radiography [Elektronische Daten] [Tetsuhiro Iguchi, Takuma Ozaki, Takaaki Chin, Nobuhiro Tsumura, Aritetsu Kanemura, Koichi Kasahara, Ryosuke Kuroda, Minoru Doita, Kotaro Nishida] Relationship between lumbar disc degeneration and segmental instability has remained controversial. Using instability factors that found close relations with symptoms in flexion-extension radiographic study, their relationship with degenerative findings was examined. More than (≥) 3mm slip in neutral position (SN), ≥3mm translation (ST), and ≥10° angulation (SA) at L4/5 segment were defined as instability factors and were applied on 447 patients who had low back and/or leg pain and satisfied inclusion criteria for accurate measurements. Radiologic findings for degeneration were disc height including three groups with different disc heights divided by mean±1 standard deviation, length of the anterior spur formation, presence of vacuum phenomenon, and endplate sclerosis. As results, group with SN factor was the oldest in age and the lowest in disc height; in contrast, group with SA was the youngest in age and the highest in disc height. The group with ST showed a mid-standing position in both age and disc height. These findings indicate that instability factors are intimately related to age and disc height. The three different disc height groups showed more anterior slip according to the progression of the disc height diminution. Presence of the apparent spur formation and/or vacuum phenomenon had an intimate relationship with the ST factor. Disc height was the most important in the examined parameters and showed an intimate relationship with age and instability factors. Although the etiology is still unknown, clinical common knowledge, that a diminution of disc height with progressive degeneration had a close relation with anterior vertebral slippage, was firstly confirmed. This study allows comprehensive understanding of segmental instability and is useful for considering surgical indications. Springer-Verlag, 2011 Lumbar spine nationallicence Disc degeneration nationallicence Instability nationallicence Radiologic sign nationallicence MRI nationallicence Iguchi Tetsuhiro Department of Rehabilitation Science, Kobe University Graduate School of Medicine in Hyogo Rehabilitation Center, 1070 Akebono-cho, Nishi-ku, 651-2181, Kobe, Japan aut Ozaki Takuma Department of Orthopaedic Surgery, Hyogo Rehabilitation Center Hospital, 1070 Akebono-cho, Nishi-ku, 651-2181, Kobe, Japan aut Chin Takaaki Department of Rehabilitation Science, Kobe University Graduate School of Medicine in Hyogo Rehabilitation Center, 1070 Akebono-cho, Nishi-ku, 651-2181, Kobe, Japan aut Tsumura Nobuhiro Department of Orthopaedic Surgery, Hyogo Rehabilitation Center Hospital, 1070 Akebono-cho, Nishi-ku, 651-2181, Kobe, Japan aut Kanemura Aritetsu Department of Orthopaedic Surgery, Kobe Rosai Hospital, 4-1-23 Kagoike-dohri, Chuo-ku, 651-0053, Kobe, Japan aut Kasahara Koichi Department of Orthopaedic Surgery, Kobe Rosai Hospital, 4-1-23 Kagoike-dohri, Chuo-ku, 651-0053, Kobe, Japan aut Kuroda Ryosuke Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Japan aut Doita Minoru Department of Orthopaedic Surgery, Takatsuki General Hospital, 1-3-13 Kosobe-cho, 569-1192, Takatsuki, Japan aut Nishida Kotaro Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Japan aut European Spine Journal Springer-Verlag 20/8(2011-08-01), 1349-1354 0940-6719 20:8<1349 2011 20 586 https://doi.org/10.1007/s00586-011-1793-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1793-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Iguchi Tetsuhiro Department of Rehabilitation Science, Kobe University Graduate School of Medicine in Hyogo Rehabilitation Center, 1070 Akebono-cho, Nishi-ku, 651-2181, Kobe, Japan aut NATIONALLICENCE 700 1- Ozaki Takuma Department of Orthopaedic Surgery, Hyogo Rehabilitation Center Hospital, 1070 Akebono-cho, Nishi-ku, 651-2181, Kobe, Japan aut NATIONALLICENCE 700 1- Chin Takaaki Department of Rehabilitation Science, Kobe University Graduate School of Medicine in Hyogo Rehabilitation Center, 1070 Akebono-cho, Nishi-ku, 651-2181, Kobe, Japan aut NATIONALLICENCE 700 1- Tsumura Nobuhiro Department of Orthopaedic Surgery, Hyogo Rehabilitation Center Hospital, 1070 Akebono-cho, Nishi-ku, 651-2181, Kobe, Japan aut NATIONALLICENCE 700 1- Kanemura Aritetsu Department of Orthopaedic Surgery, Kobe Rosai Hospital, 4-1-23 Kagoike-dohri, Chuo-ku, 651-0053, Kobe, Japan aut NATIONALLICENCE 700 1- Kasahara Koichi Department of Orthopaedic Surgery, Kobe Rosai Hospital, 4-1-23 Kagoike-dohri, Chuo-ku, 651-0053, Kobe, Japan aut NATIONALLICENCE 700 1- Kuroda Ryosuke Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Japan aut NATIONALLICENCE 700 1- Doita Minoru Department of Orthopaedic Surgery, Takatsuki General Hospital, 1-3-13 Kosobe-cho, 569-1192, Takatsuki, Japan aut NATIONALLICENCE 700 1- Nishida Kotaro Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Japan aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/8(2011-08-01), 1349-1354 0940-6719 20:8<1349 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer