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Nerve root compression in spondylolysis and spondylolisthesis
Abstracts
Herniated lumbar disc syndrome and vertebral canals Herniated lumbar disc or definite sciatica was diagnosed in 16 of 195 men and women who had reported a history of low-back pain in a health survey. Measurements related to the size and shape of the lumbar spinal canal were subsequently made from the survey radiographs and compared between various types of back syndromes. Age, body height, body mass index, occupation, and parity of women were &trolled as potential confounders using analysis of covariance. Several dimensions of lumbar vertebral canals appeared more shallow in the subjects who had herniated disc or definite sciatica than in the other ones. In particular, the interarticular distance of the first sacral vertebra was found to be narrowed in the presence of sciatica, the difference of the adjusted distances to the other back pain category being in men 30.5 mm versus 35.1 mm (P=O.O2) and in women 23.8 mm versus 30.3 mm (P=O.O02), respectively. Heliijvaara M, Vanharanta 1986; 11: 433-5
H, Korpi J, Troup JDG. Spine
Nerve root compression in spondylolysis and spondylolisthesis Thirty-four bony specimens of isthmic spondylolysis were examined and, in a significant number (32%) stenosis of the intervertebral foramen was noted. Although not emphasised in previous reports, this finding may be an important factor in the aetiology of nerve root compression when this is associated with spondylolysis and spondylolisthesis. Anatomical guidelines for adequate surgical decompression are suggested. Edelson JG, Nathan H. J Bone Joint Surg 1986; 68B: 596-9
BIOMECHANICS Valsalva maneuver biomechanics. Effects on lumbar trunk loads of elevated intraabdominal pressures The ability of a partial or full Valsalva maneuver (voluntary pressurization of the intraabdominal cavity) to unload the spine was investigated in four subjects. During the performance of five isometric tasks, intraabdominal and intradiscal pressures and surface myoelectric activities in three lumbar trunk muscle groups were measured. The tasks were carried out without voluntary pressurization of the intraabdominal cavity and then when the subjects performed partial and full Valsalva maneuvers. A biomechanical model adalysis of each task was made to help interpret the experimental measurements. Intraabdominal pressure was found not to be an indicator of spine load in these experiments. The Valsalva maneuvers did raise intraabdominal pressure, but in four of the five tasks increased rather than decreased lumbar spine compressions occurred. Nachemson AL, Andersson 11: 476-9
GBJ. Schultz AB. Spine 1986;
,A study of lumbosacral orientation under varied static loads This paper describes a study of lumbar and sacrum orientations in select standing postures with the patient holding different loads in the hands. Vertebral rotation data were gathered from two young, healthy men and two young, healthy women while they performed static lifts at two load
57
levels and in postures ranging from erect standing to deep squatting. The results disclosed a predictable reorientation of the sacrum and lumbar spine for both men and women as a function of torso and knee angles. Nonlinear second-order regression models of torso angles and knee angle versus reorientation angle were fit to the data with resulting ; values of about 0.89. Load was not found systematically to affect the sacrumllumbar reorientation. Anderson CK, Chaffin DB, Herrin GD. Spine 1986; 11: 4.56-62.
The bending stiffness of the trunk Much research is done on the physical properties of the isolated human spine. However, little knowledge exists about the relationship between the physical properties of an isolated spine and the physical properties of the whole trunk in viva. The first part of this article is a literature review. The next part is a description of experiments performed to study the bending stiffness in flexion of the whole trunk in vivo. One hundred fifty measurements were made in unanesthetized subjects and 150 in anesthetized ones. The bending stiffness of the whole trunk in vivo was found to be about 10 times larger than the mean bending stiffness of an isolated spine. Scholten PJM. Veldhuizen
AG. Spine 1986; 11: 463-7
Foot pressure measurement: a review of clinical findings In this review, a description of what is known about plantar pressure distribution in standing and in gait is followed by sections on clinical findings. Two major clinical areas are treated extensively, namely the diabetic foot and the foot in rheumatoid arthritis. Other applications, including the assessment of surgical procedures for orthopaedic corrections are also included. A large variety of different techniques for foot pressure measurement have been used; interpretation of the results has to be made on the basis of a firm understanding of the technique employed. Often, quantitative results from different pieces of apparatus are difficult to compare, indicating a need for accurate calibration and a standardized presentation. An up-to-date summary of pressure measurement systems reported over the past five years is included. Lord M, Reynolds DP. Hughes JR. J Biomed Eng 1968; 8: 283-94
The dynamic response of the human spine to sinusoidal G,-vibration. In-viva-experiments The transmission of the human spine to the vertical G,vibration was investigated in the main by measurements on the body surface and on the head. The dynamic transmission chain skin-soft tissue-bone is not linear; so it was necessary to implant K-wires into the spinous processes to get linear measurements to build up a sufficient spine model. In 11 healthy subjects the amplitude ratio of different spine segments and of the head to the OSsacrum and to the shaker was determined. These tests were performed in standing and sitting position on a shaker, which was combined with a special vibration control system. Hagena F-W, Piehler J, Wirth C-J, Hofmann GO, Zwingers Th. Neuro-Orthopedics 1986; 2: 29-33.
Herniated lumbar disc syndrome and vertebral canals Herniated lumbar disc or definite sciatica was diagnosed in 16 of 195 men and women who had reported a history of low-back pain in a health survey. Measurements related to the size and shape of the lumbar spinal canal were subsequently made from the survey radiographs and compared between various types of back syndromes. Age, body height, body mass index, occupation, and parity of women were &trolled as potential confounders using analysis of covariance. Several dimensions of lumbar vertebral canals appeared more shallow in the subjects who had herniated disc or definite sciatica than in the other ones. In particular, the interarticular distance of the first sacral vertebra was found to be narrowed in the presence of sciatica, the difference of the adjusted distances to the other back pain category being in men 30.5 mm versus 35.1 mm (P=O.O2) and in women 23.8 mm versus 30.3 mm (P=O.O02), respectively. Heliijvaara M, Vanharanta 1986; 11: 433-5
H, Korpi J, Troup JDG. Spine
Nerve root compression in spondylolysis and spondylolisthesis Thirty-four bony specimens of isthmic spondylolysis were examined and, in a significant number (32%) stenosis of the intervertebral foramen was noted. Although not emphasised in previous reports, this finding may be an important factor in the aetiology of nerve root compression when this is associated with spondylolysis and spondylolisthesis. Anatomical guidelines for adequate surgical decompression are suggested. Edelson JG, Nathan H. J Bone Joint Surg 1986; 68B: 596-9
BIOMECHANICS Valsalva maneuver biomechanics. Effects on lumbar trunk loads of elevated intraabdominal pressures The ability of a partial or full Valsalva maneuver (voluntary pressurization of the intraabdominal cavity) to unload the spine was investigated in four subjects. During the performance of five isometric tasks, intraabdominal and intradiscal pressures and surface myoelectric activities in three lumbar trunk muscle groups were measured. The tasks were carried out without voluntary pressurization of the intraabdominal cavity and then when the subjects performed partial and full Valsalva maneuvers. A biomechanical model adalysis of each task was made to help interpret the experimental measurements. Intraabdominal pressure was found not to be an indicator of spine load in these experiments. The Valsalva maneuvers did raise intraabdominal pressure, but in four of the five tasks increased rather than decreased lumbar spine compressions occurred. Nachemson AL, Andersson 11: 476-9
GBJ. Schultz AB. Spine 1986;
,A study of lumbosacral orientation under varied static loads This paper describes a study of lumbar and sacrum orientations in select standing postures with the patient holding different loads in the hands. Vertebral rotation data were gathered from two young, healthy men and two young, healthy women while they performed static lifts at two load
57
levels and in postures ranging from erect standing to deep squatting. The results disclosed a predictable reorientation of the sacrum and lumbar spine for both men and women as a function of torso and knee angles. Nonlinear second-order regression models of torso angles and knee angle versus reorientation angle were fit to the data with resulting ; values of about 0.89. Load was not found systematically to affect the sacrumllumbar reorientation. Anderson CK, Chaffin DB, Herrin GD. Spine 1986; 11: 4.56-62.
The bending stiffness of the trunk Much research is done on the physical properties of the isolated human spine. However, little knowledge exists about the relationship between the physical properties of an isolated spine and the physical properties of the whole trunk in viva. The first part of this article is a literature review. The next part is a description of experiments performed to study the bending stiffness in flexion of the whole trunk in vivo. One hundred fifty measurements were made in unanesthetized subjects and 150 in anesthetized ones. The bending stiffness of the whole trunk in vivo was found to be about 10 times larger than the mean bending stiffness of an isolated spine. Scholten PJM. Veldhuizen
AG. Spine 1986; 11: 463-7
Foot pressure measurement: a review of clinical findings In this review, a description of what is known about plantar pressure distribution in standing and in gait is followed by sections on clinical findings. Two major clinical areas are treated extensively, namely the diabetic foot and the foot in rheumatoid arthritis. Other applications, including the assessment of surgical procedures for orthopaedic corrections are also included. A large variety of different techniques for foot pressure measurement have been used; interpretation of the results has to be made on the basis of a firm understanding of the technique employed. Often, quantitative results from different pieces of apparatus are difficult to compare, indicating a need for accurate calibration and a standardized presentation. An up-to-date summary of pressure measurement systems reported over the past five years is included. Lord M, Reynolds DP. Hughes JR. J Biomed Eng 1968; 8: 283-94
The dynamic response of the human spine to sinusoidal G,-vibration. In-viva-experiments The transmission of the human spine to the vertical G,vibration was investigated in the main by measurements on the body surface and on the head. The dynamic transmission chain skin-soft tissue-bone is not linear; so it was necessary to implant K-wires into the spinous processes to get linear measurements to build up a sufficient spine model. In 11 healthy subjects the amplitude ratio of different spine segments and of the head to the OSsacrum and to the shaker was determined. These tests were performed in standing and sitting position on a shaker, which was combined with a special vibration control system. Hagena F-W, Piehler J, Wirth C-J, Hofmann GO, Zwingers Th. Neuro-Orthopedics 1986; 2: 29-33.