ISSLS PRIZE IN BIOENGINEERING SCIENCE 2018: Dynamic Imaging of Degenerative Spondylolisthesis Reveals Mid-Range Dynamic Lumbar Instability Not Evident on Static Clinical Radiographs

摘要

PurposeDegenerative spondylolisthesis (DS) in the setting of symptomatic lumbar spinal stenosis is commonly treated with spinal fusion in addition to decompression with laminectomy. However, recent studies have shown similar clinical outcomes after decompression alone, suggesting a subset of DS patients may not require spinal fusion. Identification of dynamic instability could prove useful for predicting which patients are at higher risk of post-laminectomy destabilization necessitating fusion. The goal of this study was to determine if static clinical radiographs adequately characterize dynamic instability in patients with lumbar degenerative spondylolisthesis (DS) and to compare rotational and translational kinematics in-vivo during continuous dynamic flexion activity in DS versus asymptomatic age-matched controls.