Do We Have Adequate Flexion-extension Radiographs for Evaluating Instability in Patients With Lumbar Spondylolisthesis?
Do We Have Adequate Flexion-extension Radiographs for Evaluating Instability in Patients With Lumbar Spondylolisthesis?
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DOI：
10.1097/brs.0000000000003203
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发表时间：
2020-01-01
期刊：
影响因子：
3
通讯作者：
Yamashita, Toshihiko
中科院分区：
文献类型：
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作者：
Morita, Tomonori;Yoshimoto, Mitsunori;Yamashita, Toshihiko
研究设计：一项对连续患者的回顾性队列研究。目的：研究腰椎滑脱的标准功能性X线片是否能获得足够的屈伸位。背景资料概要：在腰椎滑脱中，站立位的屈伸位X线片最常用于评估脊柱不稳。然而，这些功能X线片偶尔取决于病人的努力和合作，他们可以提供不同的result.Methods。本研究包括92例连续诊断为L4-5退行性腰椎滑脱症。我们分析了患者由手引导（LH）和无LH（NLH）时拍摄的屈伸X线片。在两项测试中拍摄的功能性X线片上测量了矢状平移（ST）、节段性成角（SA）、后开口（PO）和腰椎前凸（LL）。比较LH和NLH的ST、SA、PO、不稳定检出率和LL。结果：左侧腰椎ST段的相对值为9.5%~ 4.3%，非左侧腰椎ST段的相对值为5.6%~ 3.3%，两者差异有显著性（P
Study Design.A retrospective cohort study of consecutive patients.Objective.To investigate whether adequate flexion-extension was acquired in standard functional radiographs in lumbar spondylolisthesis.Summary of Background Data.In lumbar spondylolisthesis, flexion-extension radiographs taken in the standing position are most commonly used to evaluate spinal instability. However, these functional radiographs occasionally depend on the patient's effort and cooperation, they can provide different results.Methods.This study included 92 consecutive patients diagnosed with L4-5 degenerative lumbar spondylolisthesis. We analyzed the flexion-extension radiographs taken with the patient being led by the hand (LH) and those taken without LH (NLH). Sagittal translation (ST), segmental angulation (SA), posterior opening (PO), and lumbar lordosis (LL) were measured on functional radiographs taken in both tests. Then, ST, SA, PO, detection rate of instability, and LL observed in LH were compared with those observed in NLH. Furthermore, the correlation of the difference was evaluated between ST, lumbar angulation, and LL.Results.A relative value of ST was 9.5%4.3% in LH and 5.6%3.3% in NLH, which differed significantly (P