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Biomechanical evaluation of segmental instability in degenerative lumbar spondylolisthesis


Here we investigated the biomechanical properties of spinal segments in patients with degenerative lumbar spondylolisthesis (DLS) using a novel intraoperative measurement system. The measurement system comprised spinous process holders, a motion generator, a load cell, an optical displacement transducer, and a computer. Cyclic displacement of the holders produced flexion-extension of the segment with all ligamentous structures intact. Stiffness, absorption energy (AE), and neutral zone (NZ) were determined from the load-deformation data. Forty-one patients with DLS (M/F = 15/26, mean age 68.6 years; Group D) were studied. Adjacent segments with normal discs in six patients (M/F = 3/3, mean age 35 years) were included as a control group (Group N). Flexion stiffness was significantly lower in Group D than in Group N. The NZ, however, was significantly greater in Group D than in Group N. Thus, compared to normal segments, spinal segments with DLS had a lower flexion stiffness and a higher NZ. NZs in Group D were, however, widely distributed compared to those in Group N that showed NZ <2 mm/N in all cases, suggesting that the segment with DLS is not always unstable and that the segments with NZ >2 mm/N can be considered as unstable.

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Conflict of interest statement

No grant or any other funding has been recieved.

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Correspondence to Kazuhiro Hasegewa.

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A patent application for the intraoperative measurement system has been submitted.

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Hasegewa, K., Kitahara, K., Hara, T. et al. Biomechanical evaluation of segmental instability in degenerative lumbar spondylolisthesis. Eur Spine J 18, 465–470 (2009). https://doi.org/10.1007/s00586-008-0842-3

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  • Intraoperative biomechanical analysis
  • Lumbar degenerative spondylolisthesis
  • Segmental instability