Skip to main content
SpringerLink
Log in

In vivo segmental vertebral kinematics in patients with degenerative lumbar scoliosis

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to find a standard of the vertebra kinematics during functional weight-bearing activities in degenerative lumbar scoliosis (DLS) patients.

Methods

Fifty-four patients were involved into this study with forty-two in DLS group and twelve in the control group. The three-dimensional (3D) vertebral models from L1 to S1 of each participant were reconstructed by computed tomography (CT). Dual-orthogonal fluoroscopic imaging, along with FluoMotion and Rhinoceros software, was used to record segmental vertebral kinematics during functional weight-bearing activities. The primary and coupled motions of each vertebra were analyzed in patients with DLS.

Results

During flexion–extension of the trunk, anteroposterior (AP) translation and craniocaudal (CC) translation at L5–S1 were higher than those at L2–3 (9.3 ± 5.1 mm vs. 6.4 ± 3.5 mm; P < 0.05). The coupled mediolateral (ML) translation at L5–S1 in patients with DLS was approximately three times greater than that in the control group. During left–right bending of the trunk, the coupled ML rotation at L5–S1 was higher in patients with DLS than that in the control group (17.7 ± 10.3° vs. 8.4 ± 4.4°; P < 0.05). The AP and CC translations at L5–S1 were higher than those at L1–2, L2–3, and L3–4. During left–right torsion of the trunk, the AP translation at L5–S1 was higher as compared to other levels.

Conclusions

The greatest coupled translation was observed at L5–S1 in patients with DLS. Coupled AP and ML translations at L5–S1 were higher than those in healthy participants. These data improved the understanding of DLS motion characteristics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Aebi M (2005) The adult scoliosis. Eur Spine J 14(10):925–948. https://doi.org/10.1007/s00586-005-1053-9

    Article  PubMed  Google Scholar 

  2. Battié MC, Videman T (2006) Lumbar disc degeneration: epidemiology and genetics. J Bone Joint Surg Am 88(Suppl 2):3–9. https://doi.org/10.2106/jbjs.e.01313

    Article  PubMed  Google Scholar 

  3. Carter OD, Haynes SG (1987) Prevalence rates for scoliosis in US adults: results from the first National Health and Nutrition Examination Survey. Int J Epidemiol 16(4):537–544. https://doi.org/10.1093/ije/16.4.537

    Article  CAS  PubMed  Google Scholar 

  4. Gupta MC (2003) Degenerative scoliosis. Options for surgical management. Orthop Clin North Am 34(2):269–279. https://doi.org/10.1016/s0030-5898(03)00029-4

    Article  PubMed  Google Scholar 

  5. Pérennou D, Marcelli C, Hérisson C, Simon L (1994) Adult lumbar scoliosis. Epidemiologic aspects in a low-back pain population. Spine (Phila Pa 1976) 19(2):123–128. https://doi.org/10.1097/00007632-199401001-00001

    Article  PubMed  Google Scholar 

  6. Robin GC, Span Y, Steinberg R, Makin M, Menczel J (1982) Scoliosis in the elderly: a follow-up study. Spine (Phila Pa 1976) 7(4):355–359. https://doi.org/10.1097/00007632-198207000-00005

    Article  CAS  PubMed  Google Scholar 

  7. Bridwell KH, Glassman S, Horton W, Shaffrey C, Schwab F, Zebala LP, Lenke LG, Hilton JF, Shainline M, Baldus C, Wootten D (2009) Does treatment (nonoperative and operative) improve the two-year quality of life in patients with adult symptomatic lumbar scoliosis: a prospective multicenter evidence-based medicine study. Spine (Phila Pa 1976) 34(20):2171–2178. https://doi.org/10.1097/BRS.0b013e3181a8fdc8

    Article  PubMed  Google Scholar 

  8. Bradford DS, Tay BK, Hu SS (1999) Adult scoliosis: surgical indications, operative management, complications, and outcomes. Spine (Phila Pa 1976) 24(24):2617–2629. https://doi.org/10.1097/00007632-199912150-00009

    Article  CAS  PubMed  Google Scholar 

  9. Brown KM, Ludwig SC, Gelb DE (2004) Radiographic predictors of outcome after long fusion to L5 in adult scoliosis. J Spinal Disord Tech 17(5):358–366. https://doi.org/10.1097/01.bsd.0000112080.04960.67

    Article  PubMed  Google Scholar 

  10. Emami A, Deviren V, Berven S, Smith JA, Hu SS, Bradford DS (2002) Outcome and complications of long fusions to the sacrum in adult spine deformity: luque-galveston, combined iliac and sacral screws, and sacral fixation. Spine (Phila Pa 1976) 27(7):776–786. https://doi.org/10.1097/00007632-200204010-00017

    Article  PubMed  Google Scholar 

  11. Grubb SA, Lipscomb HJ, Suh PB (1994) Results of surgical treatment of painful adult scoliosis. Spine (Phila Pa 1976) 19(14):1619–1627. https://doi.org/10.1097/00007632-199407001-00011

    Article  CAS  PubMed  Google Scholar 

  12. Winter RB, Denis F, Lonstein JE, Dezen E (1991) Salvage and reconstructive surgery for spinal deformity using Cotrel-Dubousset instrumentation. Spine (Phila Pa 1976) 16(8 Suppl):S412–S417

    CAS  PubMed  Google Scholar 

  13. Wang W, Baran GR, Betz RR, Samdani AF, Pahys JM, Cahill PJ (2014) The use of finite element models to assist understanding and treatment for scoliosis: a review paper. Spine Deform 2(1):10–27. https://doi.org/10.1016/j.jspd.2013.09.007

    Article  PubMed  Google Scholar 

  14. Bisschop A, Holewijn RM, Kingma I, Stadhouder A, Vergroesen PP, van der Veen AJ, van Dieën JH, van Royen BJ (2015) The effects of single-level instrumented lumbar laminectomy on adjacent spinal biomechanics. Global Spine J 5(1):39–48. https://doi.org/10.1055/s-0034-1395783

    Article  PubMed  Google Scholar 

  15. Bisschop A, van Engelen SJ, Kingma I, Holewijn RM, Stadhouder A, van der Veen AJ, van Dieën JH, van Royen BJ (2014) Single level lumbar laminectomy alters segmental biomechanical behavior without affecting adjacent segments. Clin Biomech (Bristol, Avon) 29(8):912–917. https://doi.org/10.1016/j.clinbiomech.2014.06.016

    Article  PubMed  Google Scholar 

  16. Busscher I, van Dieën JH, Kingma I, van der Veen AJ, Verkerke GJ, Veldhuizen AG (2009) Biomechanical characteristics of different regions of the human spine: an in vitro study on multilevel spinal segments. Spine (Phila Pa 1976) 34(26):2858–2864. https://doi.org/10.1097/BRS.0b013e3181b4c75d

    Article  PubMed  Google Scholar 

  17. Wilke HJ, Wenger K, Claes L (1998) Testing criteria for spinal implants: recommendations for the standardization of in vitro stability testing of spinal implants. Eur Spine J 7(2):148–154. https://doi.org/10.1007/s005860050045

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Haddas R, Xu M, Lieberman I, Yang J (2019) Finite element based-analysis for pre and post lumbar fusion of adult degenerative scoliosis patients. Spine Deform 7(4):543–552. https://doi.org/10.1016/j.jspd.2018.11.008

    Article  PubMed  Google Scholar 

  19. Park WM, Kim K, Kim YH (2013) Effects of degenerated intervertebral discs on intersegmental rotations, intradiscal pressures, and facet joint forces of the whole lumbar spine. Comput Biol Med 43(9):1234–1240. https://doi.org/10.1016/j.compbiomed.2013.06.011

    Article  PubMed  Google Scholar 

  20. Li G, Wang S, Passias P, Xia Q, Li G, Wood K (2009) Segmental in vivo vertebral motion during functional human lumbar spine activities. Eur Spine J 18(7):1013–1021. https://doi.org/10.1007/s00586-009-0936-6

    Article  PubMed  PubMed Central  Google Scholar 

  21. Shin JH, Wang S, Yao Q, Wood KB, Li G (2013) Investigation of coupled bending of the lumbar spine during dynamic axial rotation of the body. Eur Spine J 22(12):2671–2677. https://doi.org/10.1007/s00586-013-2777-6

    Article  PubMed  PubMed Central  Google Scholar 

  22. Wu M, Wang S, Driscoll SJ, Cha TD, Wood KB, Li G (2014) Dynamic motion characteristics of the lower lumbar spine: implication to lumbar pathology and surgical treatment. Eur Spine J 23(11):2350–2358. https://doi.org/10.1007/s00586-014-3316-9

    Article  PubMed  Google Scholar 

  23. Wang S, Passias P, Li G, Li G, Wood K (2008) Measurement of vertebral kinematics using noninvasive image matching method-validation and application. Spine (Phila Pa 1976) 33(11):E355–E361. https://doi.org/10.1097/BRS.0b013e3181715295

    Article  PubMed  Google Scholar 

  24. Roman I, Luyten M, Croonenborghs H, Lason G, Peeters L, Byttebier G, Comhaire F (2019) Relating the Diers formetric measurements with the subjective severity of acute and chronic low back pain. Med Hypotheses 133:109390. https://doi.org/10.1016/j.mehy.2019.109390

    Article  PubMed  Google Scholar 

  25. Passias PG, Wang S, Kozanek M, Xia Q, Li W, Grottkau B, Wood KB, Li G (2011) Segmental lumbar rotation in patients with discogenic low back pain during functional weight-bearing activities. J Bone Joint Surg Am 93(1):29–37. https://doi.org/10.2106/jbjs.i.01348

    Article  PubMed  PubMed Central  Google Scholar 

  26. Li W, Wang S, Xia Q, Passias P, Kozanek M, Wood K, Li G (2011) Lumbar facet joint motion in patients with degenerative disc disease at affected and adjacent levels: an in vivo biomechanical study. Spine (Phila Pa 1976) 36(10):E629–E637. https://doi.org/10.1097/BRS.0b013e3181faaef7

    Article  PubMed  Google Scholar 

  27. Yao Q, Wang S, Shin JH, Li G, Wood KB (2013) Lumbar facet joint motion in patients with degenerative spondylolisthesis. J Spinal Disord Tech 26(1):E19-27. https://doi.org/10.1097/BSD.0b013e31827a254f

    Article  PubMed  PubMed Central  Google Scholar 

  28. Wang L, Zhang B, Chen S, Lu X, Li ZY, Guo Q (2016) A validated finite element analysis of facet joint stress in degenerative lumbar scoliosis. World Neurosurg 95:126–133. https://doi.org/10.1016/j.wneu.2016.07.106

    Article  PubMed  Google Scholar 

  29. Zheng J, Yang Y, Lou S, Zhang D, Liao S (2015) Construction and validation of a three-dimensional finite element model of degenerative scoliosis. J Orthop Surg Res 10:189. https://doi.org/10.1186/s13018-015-0334-1

    Article  PubMed  PubMed Central  Google Scholar 

  30. Rustenburg CME, Kingma I, Holewijn RM, Faraj SSA, van der Veen A, Bisschop A, de Kleuver M, Emanuel KS (2020) Biomechanical properties in motion of lumbar spines with degenerative scoliosis. J Biomech 102:109495. https://doi.org/10.1016/j.jbiomech.2019.109495

    Article  PubMed  Google Scholar 

  31. Veldhuizen AG, Scholten PJ (1987) Kinematics of the scoliotic spine as related to the normal spine. Spine (Phila Pa 1976) 12(9):852–858. https://doi.org/10.1097/00007632-198711000-00005

    Article  CAS  PubMed  Google Scholar 

  32. du Rose A, Breen A (2016) Relationships between paraspinal muscle activity and lumbar inter-vertebral range of motion. Healthcare (Basel). https://doi.org/10.3390/healthcare4010004

    Article  PubMed  PubMed Central  Google Scholar 

  33. Sadler SG, Spink MJ, Ho A, De Jonge XJ, Chuter VH (2017) Restriction in lateral bending range of motion, lumbar lordosis, and hamstring flexibility predicts the development of low back pain: a systematic review of prospective cohort studies. BMC Musculoskelet Disord 18(1):179. https://doi.org/10.1186/s12891-017-1534-0

    Article  PubMed  PubMed Central  Google Scholar 

  34. Ploumis A, Transfledt EE, Denis F (2007) Degenerative lumbar scoliosis associated with spinal stenosis. Spine J 7(4):428–436. https://doi.org/10.1016/j.spinee.2006.07.015

    Article  PubMed  Google Scholar 

  35. Edwards CC 2nd, Bridwell KH, Patel A, Rinella AS, Berra A, Lenke LG (2004) Long adult deformity fusions to L5 and the sacrum. A matched cohort analysis. Spine (Phila Pa 1976) 29(18):1996–2005

    Article  PubMed  Google Scholar 

  36. Horton WC, Holt RT, Muldowny DS (1996) Controversy. Fusion of L5–S1 in adult scoliosis. Spine (Phila Pa 1976) 21(21):2520–2522. https://doi.org/10.1097/00007632-199611010-00024

    Article  CAS  PubMed  Google Scholar 

  37. Simmons ED Jr, Kowalski JM, Simmons EH (1993) The results of surgical treatment for adult scoliosis. Spine (Phila Pa 1976) 18(6):718–724. https://doi.org/10.1097/00007632-199305000-00008

    Article  PubMed  Google Scholar 

Download references

Funding

This article is supported by the National Natural Science Foundation of China (Grant No. 81871807).

Author information

Author notes

  1. Fei Xu and Jialiang Lin contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedics, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China

    Fei Xu, Jialiang Lin, Shuai Jiang, Zhuoran Sun, Siyu Zhou, Zhuofu Li & Weishi Li

  2. Peking University Health Science Center, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China

    Fei Xu & Zhuofu Li

  3. Beijing Key Laboratory of Spinal Disease Research, Beijing, China

    Fei Xu, Jialiang Lin, Shuai Jiang, Zhuoran Sun, Siyu Zhou, Zhuofu Li & Weishi Li

  4. Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China

    Fei Xu, Jialiang Lin, Shuai Jiang, Zhuoran Sun, Siyu Zhou, Zhuofu Li & Weishi Li

  5. Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of Kinesiology, Shanghai University of Sport, Shanghai, 20043, China

    Shaobai Wang

Authors
  1. Fei Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jialiang Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shuai Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zhuoran Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Siyu Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zhuofu Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shaobai Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Weishi Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Shaobai Wang or Weishi Li.

Ethics declarations

Conflict of interest

There is no conflict of interest.

Ethics approval and consent to participate

This study was approved by the institutional review board of the hospital.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xu, F., Lin, J., Jiang, S. et al. In vivo segmental vertebral kinematics in patients with degenerative lumbar scoliosis. Eur Spine J 33, 571–581 (2024). https://doi.org/10.1007/s00586-023-07974-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-023-07974-0

Keywords

Search

Navigation