radiologic lumbar instability

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2, 4 August 2013 | European Spine Journal, Vol. Radiographic evaluation of ventral instability in lumbar spondylolisthesis: do we need extension radiographs in routine exams? 1, Journal of Physiological Anthropology, Vol. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. 30, No. Lumbar spinal segmental instability is frequently cited as a cause of low backache but its clinical symptoms and signs are non-specific. 47, No. Either of the sagittal and coronal dimensions or total canal area are measured in square centimeters (cm 2) . 27, No. 2, World Journal of Radiology, Vol. 3, Radiologic Clinics of North America, Vol. Overt instability is excessive motion that is supported by radiographic studies and results in pain, deformity, or neurological deficits. 27, No. 12, 10 September 2016 | Skeletal Radiology, Vol. 12, No. Abstract: Lumbar instability of the lumbar spine is thought to be a possible mechanical mechanism underlying low back pain and is often an important factor in determining surgical indication for spinal fusion and decompression. 40, No. 7, No. 3, 21 May 2016 | Neuroradiology, Vol. Background: The relationship between radiologic instability and its symptoms is controversial. 52, No. Which Radiographic Parameters Are Linked to Failure of a Dynamic Spinal Implant? Degenerative lumbar intervertebral instability as a cause of chronic LBP is an important factor in determining indications for spinal surgery. 23, 31 October 2014 | Child's Nervous System, Vol. 95, No. Instability of the lumbar spine, however, remains a poorly understood subject. 82, No. Phys Ther. 8, Chinese Neurosurgical Journal, Vol. 2, 17 March 2012 | European Spine Journal, Vol. 44, No. 4, Mechanics Research Communications, Vol. Three-Year Results of a Swiss Prospective Multicenter Cohort Study, Superior Segment Facet Joint Violation During Instrumented Lumbar Fusion is Associated With Higher Reoperation Rates and Diminished Improvement in Quality of Life, Uneven intervertebral motion sharing is related to disc degeneration and is greater in patients with chronic, non-specific low back pain: an in vivo, cross-sectional cohort comparison of intervertebral dynamics using quantitative fluoroscopy, Altered postural sway during quiet standing in women with clinical lumbar instability, Treatment of 44 Cases With Lumbar Spine Stenosis and Degenerative Instability: Outcomes of Surgical Intervention, Lateral Lumbar Interbody Fusion and in Situ Screw Fixation for Rostral Adjacent Segment Stenosis of the Lumbar Spine, Influence of spinal disc translational stiffness on the lumbar spinal loads, ligament forces and trunk muscle forces during upper body inclination, Assessment of cervical disk prosthesis by means of video-fluoroscopy image processing, Clinical Differences Between Monomicrobial and Polymicrobial Vertebral Osteomyelitis, Association between vertebral cross-sectional area and lumbar lordosis angle in adolescents, The outcomes of chemotherapy only treatment on mild spinal tuberculosis, Degeneration and Instability and the Relation to Patients’ Function Late After Lumbar Disc Surgery, Invagination of intra-abdominal structures in the lumbar intervertebral disc space, Computed Tomography Findings Associated with Clinical Outcome After Dynamic Posterior Stabilization of the Lumbar Spine, Assessment of Lumbar Spine Instability Using C-Arm Fluoroscopy, Interobserver reproducibility of radiographic evaluation of lumbar spine instability, Facet orientation and tropism: Associations with asymmetric lumbar paraspinal and psoas muscle parameters in patients with chronic low back pain, Dynamic MR in patients affected by neurogenical claudication: technique and results from a single-center experience, Accuracy and repeatability of quantitative fluoroscopy for the measurement of sagittal plane translation and finite centre of rotation in the lumbar spine, STUDY OF VARIATION OF THE DIAMETER OF THE SPINAL CANAL AND THE FORAMINA IN SPONDYLOLISTHESIS, Predictors of Reoperation after Microdecompression in Lumbar Spinal Stenosis, Arguments for the choice of surgical treatments in patients with lumbar spinal stenosis – a systematic appraisal of randomized controlled trials, Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis, The inter-rater reliability of clinical tests that best predict the subclassification of lumbar segmental instability: structural, functional and combined instability, Hidden spondylolisthesis: unrecognized cause of low back pain? 11, Journal of the American Academy of Physician Assistants, Vol. A lumbar motion segment is considered to be unstable when it exhibits abnormal movement. 9, Journal of Back and Musculoskeletal Rehabilitation, Vol. 45, No. This movement can be abnormal in quality (abnormal coupling patterns) or in quantity (abnormal increased motion). The role of imaging in the pre- and postoperative evaluation of posterior occipito-cervical fusion, Some comments on the absence of buckling of the ligamentous human spine in the sagittal plane, The analysis of segmental mobility with different lumbar radiographs in symptomatic patients with a spondylolisthesis, A continuous description of intervertebral motion by means of spline interpolation of kinematic data extracted by videofluoroscopy, Advanced template matching method for estimation of intervertebral kinematics of lumbar spine, Correlation Between Vacuum Phenomenon on CT and Fluid on MRI in Degenerative Disks, Intimate relationship between instability and degenerative signs at L4/5 segment examined by flexion–extension radiography, Lumbar epidural gas-containing pseudocysts as a cause of severe radicular pain, Pseudokystes gazeux lombaires épiduraux, une cause rare de douleur radiculaire sévère, Characterization of articulation of the lumbar facets in the human cadaveric spine using a facet-based coordinate system, The fall of the postural-structural-biomechanical model in manual and physical therapies: Exemplified by lower back pain, Correlação entre instabilidade radiográfica e presença do sinal de modic, La radiografía simple en el estudio del dolor de la columna vertebral, Plain-film radiography in the study of spinal pain, Role of Imaging in Spine, Hand, and Wrist Osteoarthritis, Osteoarthritis of the Wrist and Hand, and Spine, Differences in lumbopelvic motion between people with and people without low back pain during two lower limb movement tests, Effects of body position and clinical signs on L7-S1 intervertebral foraminal area and lumbosacral angle in dogs with lumbosacral disease as measured via computed tomography, What to do when neck pain is more than just a simple pain in the neck, Imaging and Radiologic Nomenclature of the Degenerative Spine, New Techniques in Lumbar Spinal Instrumentation: What the Radiologist Needs to Know, Percutaneous Facet Screw Fixation of Lumbar Spine with CT and Fluoroscopic Guidance: A Feasibility Study, The Art of Interpreting Cervical Spine Radiographs, Spinal Ligamentous Injuries MRI Evaluation. 470, No. With signs of instability the spine surgeon might choose a fusion of the vertebrae. 33, No. Enter your email address below and we will send you the reset instructions. 10, American Journal of Roentgenology, Vol. 8, Magnetic Resonance Imaging Clinics of North America, Vol. Although the presence of spinal instability does not always equate to symptoms directly related to the instability, spinal imaging in combination with clinical history and physical examination can provide valuable insights into the preoperative evaluation of patients, the selection of treatment options, and the subsequent postoperative follow-up. 478, No. 10, 30 March 2015 | Journal of Manual & Manipulative Therapy, Vol. 1998; 78: 889– 896. 197, No. JF Behrsin. Part II: Spinal instability, Measurement of Intervertebral Cervical Motion by Means of Dynamic X-Ray Image Processing and Data Interpolation, Instability of the lumbar spine due to disc degeneration. Crossref Medline Google Scholar; 23. Summary of Background Data. - Neurologic complications and lumbar laminectomy. 23, No. 1, International Journal of Biomedical Imaging, Vol. 27, No. 1, Journal of Physical Therapy Science, Vol. 3, No. 4, Journal of Womenʼs Health Physical Therapy, Vol. At present, much controversy exists regarding the proper definition of the condition, the best diagnostic methods, and the most efficacious treatment approaches. 45, No. 5, 25 March 2013 | Pain Practice, Vol. Copyright © 2005 Elsevier Inc. All rights reserved. Because of its simplicity, … 1, Investigative Magnetic Resonance Imaging, Vol. The finding that radiological instability was highest at the L 4–5 segment is similar to the findings of other studies. Fritz JM, , Piva SR, , Childs JD. Nizard RS (1), Wybier M, Laredo JD. This movement can be abnormal in quality (abnormal coupling patterns) or in quantity (abnormal increased motion). 32, No. 21, No. 38, No. 3, Seminars in Spine Surgery, Vol. Study Design. 33, No. 04, No. 43, No. Progressive postoperative spondylolisthesis occurred in 31% of patients with normal preoperative alignment (mean 7.8 mm, range 2-20 mm) and in 73% of patients … 40, 14 June 2011 | European Spine Journal, Vol. Assessing severity of lumbar spinal stenosis. 4, 1 December 2012 | Neurosurgical Review, Vol. Eur Spine J. Andrews FJ: Lumbar :;egmental instability: Manual assessment findings supported by rad iological measurement (A case study). 35, No. Rating. 14, No. 2, Medical Engineering & Physics, Vol. 21, No. At present, much controversy exists regarding the proper definition of the condition, the best diagnostic methods, and the most efficacious treatment approaches. 69, No. and Accuracy of the clinical examination to predict radiographic instability of the lumbar spine. Lumbar Spinal Stenosis: Who Should Be Fused? clinical instability of the lumbar spine will be presented and discussed. 4, Journal of Back and Musculoskeletal Rehabilitation, Vol. 6, European Journal of Radiology, Vol. 6, 14 November 2016 | Orthopedics, Vol. 36, No. 57, No. Radiol Clin North Am 2001; 39:55–71, v–vi [Google Scholar] 64. 20, No. The word ‘instability’ is still poorly defined. ABSTRACT : An attempt was made to define more precisely the notion of spine instability in lumbar spondylolisthesis. To investigate the proportion and relationship of three individual radiologic factors with age on segmental instability in sagittal plane in consecu 15, No. 21, No. 9, Magnetic Resonance Imaging Clinics of North America, Vol. Prospective study about the use of dynamic projections in standing and recumbent position for the individuation of lumbar instability, Kinematic analysis of diseased and adjacent segments in degenerative lumbar spondylolisthesis, Spinal involvement in mucopolysaccharidoses: a review, Comparison between the dynamic and initial creep response of porcine and human lumbar intervertebral discs, Evaluation and Treatment Strategies for Care of the Injured Lumbar Spine After a Motor Vehicle Accident, Proportional lumbar spine inter-vertebral motion patterns: a comparison of patients with chronic, non-specific low back pain and healthy controls, Single level lumbar laminectomy alters segmental biomechanical behavior without affecting adjacent segments, The Difference in Superior Adjacent Segment Pathology After Lumbar Posterolateral Fusion by Using 2 Different Pedicle Screw Insertion Techniques in 9-Year Minimum Follow-up, Correlation of Axial Vertebral Rotation with Nerve Root Involvement: The First Clinical Study in Literature, Lumbar Zygapophyseal Pain During Extension-Based Stabilization Protocol Following Lumbar Transdiscal Biacuplasty. 1, Journal of Physical Therapy Science, Vol. Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis Author NIZARD, Rémy S 1; WYBIER, Marc 2; LAREDO, Jean-Denis 2 [1] Department of Orthopaedic Surgery, Hôpital Lariboisière, Assistance Publique des Hôpitaux de Paris, Paris, France Dedicated images with sagittal and coronal reformat or derived from TAP scan. 53, 5 February 2018 | European Spine Journal, Vol. 22, No. Australian Journal of Physiotherapy37: 171-173. Pain immediately upon sitting down and relieved by standing up is often associated with radiologic lumbar instability or marked anterior loss of disc space 5, 21 April 2011 | European Spine Journal, Vol. Previous authors consider flexion-extension radiographs to be of little value in evaluating instability; however, the current authors consider the variation of results in evaluating radiologic instability to be the result of limitations in previous researchers' methods. Cross-sectional study of 880 outpatients with low back and/or leg pain regarding age distribution of three radiologic factors.Objectives. … B App Sc (Phty). 11, No. By continuing you agree to the use of cookies. 4, No. 23, No. Radiological evaluation of lumbar intervertebrak instability: Alam A 48 S pinal instability is frequently mentioned, rarely defined and remains a controversial concept due to lack of well-defined clinical or radiological criteria for its evaluation [1]. 10, Journal of Medical Sciences, Vol. - Radiologic diagnosis of degenerative lumbar spinal instability. 40, No. Seven patients (6%) developed lumbar instability, three patients (2%) developed new stenosis at an adjacent unoperated level, and three patients (2%) developed a new disc herniation between 2 and 5 years after surgery. 1, Journal of Evolution of Medical and Dental Sciences, Vol. Progressive postoperative spondylolisthesis occurred in 31% of patients with normal preoperative alignment (mean 7.8 mm, range 2–20 mm) and in 73% of patients … 23, No. and Segmental instability of the lumbar spine. 1, 17 July 2015 | European Spine Journal, Vol. 3, Medical Engineering & Physics, Vol. 29, No. aco66100@par.odn.ne.jp Study Design. 4, Hirurgiâ pozvonočnika (Spine Surgery), Vol. Instability secondary to other common causes such as trauma, congenital anomalies, deformity, inflammatory disorders, and prior surgery are outside the scope of this review. This article reviews the radiology of spinal instability in patients with degenerative disc disease. Objectives. Neurologic abnormalities. Lumbar instability is an important cause of low back pain and can be associated with substantial disability. Lumbar instability can be classified into two types: radiological and clinical [23]. Grad Dip Manip Ther. 5, 22 March 2018 | Insights into Imaging, Vol. 04, World Journal of Orthopedics, Vol. Siemund R, Thurnher M, Sundgren PC. 11, Journal of Orthopaedic & Sports Physical Therapy, Vol. A continuing-education service for chiropractors & other manual-medicine providers offering affordable, evidence-informed & clinically applicable subscription to weekly research reviews of evidence-based scientific information, live seminars & online credit-hour courses. 9. This instability is diagnosed using diagnostic imaging. 15, 25 August 2018 | Current Pain and Headache Reports, Vol. Radiological lumbar instability is typically diagnosed by using flexion-extension radiographs of the lumbar spine [2,24,25]. 16, No. Modern continuous motion analysis using cineradiography or videofluoroscopy can more accurately evaluate and compare quantitative lumbar motion profiles and facilitate the diagnosis of spinal segmental instability.9, 34, 35, 36, 37 However, in the clinical setting, radiologic studies that are used most often to determine clinical instability include plain radiographs, magnetic resonance … Overt instability generally requires stabilization either by external or internal means. 7, 28 August 2013 | Sports Health: A Multidisciplinary Approach, Vol. Instability of the lumbar spine, however, remains a controversial and poorly understood topic. Lumbar instability can be classified into two types: radiological and clinical. Typically 'mild' to 'moderate' stenosis is described as less … 7, 28 March 2014 | European Spine Journal, Vol. 6, North American Spine Society Journal (NASSJ), Vol. 23, No. If the address matches an existing account you will receive an email with instructions to reset your password. 2, BMC Musculoskeletal Disorders, Vol. Comments. A finite element simulation, Common surgical complications in degenerative spinal surgery. 33, No. 20, No. 2, 29 May 2017 | European Spine Journal, Vol. 1, Journal of Neurosurgery: Spine, Vol. 9, No. 2, 28 February 2017 | PLOS ONE, Vol. 7, 21 September 2017 | European Spine Journal, Vol. 2, European Journal of Radiology, Vol. 2, 14 May 2016 | Journal of Orthopaedic Surgery and Research, Vol. 38, No. To investigate the proportion and relationship of three individual radiologic factors with age on segmental instability in sagittal plane in consecutive age groups. 1991] O Key words: Lumbosacral region; Backache; Radiography; Physical examination. The term ‘instability’ has crept into the literature on low back pain as a diagnostic entity. Intervertebral instability of the lumbar spine is thought to be a possible pathomechanical mechanism underlying low back pain and sciatica and is often an important factor in determining surgical indication for spinal fusion and decompression. 1, American Journal of Physical Medicine & Rehabilitation, Vol. 1, 7 November 2018 | Orthopaedic Surgery, Vol. 12, Journal of Spinal Disorders & Techniques, Vol. By means of lateral radiographs in flexion and extnsion, the axes of movement and the degree of mobility at the L3--L4, L4--L5, and L5--S1 levels were determined in 24 cases of true (spondylolytic) spondylolisthesis. https://doi.org/10.1053/j.semss.2005.10.002. The best diagnostic methods and the most efficacious treatment approaches are … Adjacent Segment Degeneration After Lumbar Dynamic Stabilization Using Pedicle Screws and a Nitinol Spring Rod System With 2-year Minimum Follow-up, Pelvic Incidence and Lumbar Spine Instability Correlations in Patients with Chronic Low Back Pain, Grade three disc degeneration is a critical stage for anterior spondylolisthesis in lumbar spine. 50, No. In this article, we provide an overview of the current concepts of vertebral instability, focusing on degenerative lumbar intervertebral instability, and review the different imaging modalities most indicated in diagnosing vertebral instability. The American Academy of Orthopaedics Surgeons state: ‘Segmental instability is an abnormal response to applied loads, characterized by motion in motion … Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis. A lumbar motion segment is considered to be unstable when it exhibits abnormal movement. - Morbidity and mortality in association with operations on the lumbar spine. 14, No. The implication is that the patient has something wrong biomechanically in their back, and that this is somehow the cause of their pain. The concept of lumbar instability remains a subject of considerable debate. 21, No. 4, No. We use cookies to help provide and enhance our service and tailor content and ads. OBJECTIVEIn this study the authors sought to compare the proportion of patients with lumbar spondylolisthesis detected to have dynamic instability based on flexion and extension standing radiographs versus neutral standing radiograph and supine MRI.METHODSThis was a single-center retrospective study of all consecutive adult patients diagnosed with spondylolisthesis from January 1, … 60, No. Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis. 8, 4 May 2010 | Skeletal Radiology, Vol. 5, 11 March 2015 | Cochrane Database of Systematic Reviews, Vol. 24, No. 31, No. Leone A, Guglielmi G, Cassar-Pullicino VN, Bonomo L. Lumbar intervertebral instability: a review. In an era of increasing use of spinal hardware whether for fusion or to preserve segmental motion, radiologic determination of spinal instability plays a prominent role in the treatment algorithm for practically all disorders affecting the spine. 4, 10 April 2012 | European Spine Journal, Vol. Despite many efforts, there is no clear and widely accepted definition of lumbar instability because there are no unquestionable and currently applicable clinical or radiologic criteria available for this entity. Pain is a signal of Impending or actual tissue damage, and when present it indicates … An Updated Review, Unilateral pedicle screw fixation through a tubular retractor via the Wiltse approach compared with conventional bilateral pedicle screw fixation for single-segment degenerative lumbar instability: a prospective randomized study, Injectable, High Modulus, And Fatigue Resistant Composite Scaffold for Load-Bearing Soft Tissue Regeneration, Traumatic Thoracolumbar Spine Injuries: What the Spine Surgeon Wants to Know, Core Stabilization Exercise Prescription, Part I, Spinal Deformity in Aged Zebrafish Is Accompanied by Degenerative Changes to Their Vertebrae that Resemble Osteoarthritis, Association of Benign Joint Hypermobility With Spinal Segmental Motion and Its Clinical Implication in Active Young Males. 58, No. MRI thoracic or lumbar spine without contrast. 3, No. 20, No. 5, No. 117, No. 22, No. 2007;245(1):62-77. 7, 22 April 2015 | BMC Musculoskeletal Disorders, Vol. 24, No. Clinical presentation is not specific, and the relationship between radiologic evidence of instability and its symptoms is controversial. How to image patients with spine pain. This instability can be symptomatic or asymptomatic, depending on the demands made on the motion segment. What are the comparative radiologic and procedural outcomes of single versus multiple transpsoas fusions during DLIF in patients requiring surgery for spinal instability? Iguchi T(1), Kanemura A, Kasahara K, Kurihara A, Doita M, Yoshiya S. Author information: (1)Department of Orthopaedic Surgery, Kobe Rosai Hospital, Kobe, Japan. MSc. 25, No. Correspondence to: Wickham Road Spinal … 6, 24 September 2013 | PLoS ONE, Vol. 10, Journal of Clinical Neuroscience, Vol. 4, 17 November 2011 | La radiologia medica, Vol. 2001;39(1):55-71, v-vi. 46, No. - Non Operative Treatment: - high percentage of patients will ... - Postdecompression lumbar instability. Variant 10: Blunt trauma meeting criteria for thoracic or lumbar imaging. Anticipated instability refers to instability that would be produced by a surgical procedure that is required for proper decompression of neural elements or resection of an offending lesion. 6, Journal of Bodywork and Movement Therapies, Vol. 9. 4, American Journal of Veterinary Research, Vol. Clinical presentation is not specific, and the relationship between radiologic evidence of instability and its symptoms is controversial. 2, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques, Vol. 4, © 2020 Radiological Society of North America, Lumbar Intervertebral Instability: A Review, https://doi.org/10.1148/radiol.2451051359, Prospective Study of Long-term Effect between Multifidus Muscle Bundle and Conventional Open Approach in One-level Posterior Lumbar Interbody Fusion, Informed appropriate imaging for low back pain management: A narrative review, The Role of Imaging in the Management of Cystic Formations of the Mobile Spine (CYFMOS), Lumbar synovial cyst with chronic viral hepatitis: A case series and literature review, Decompression with or without concomitant fusion in lumbar stenosis due to degenerative spondylolisthesis: a systematic review, Lumbosacral Transitional Vertebra-Related Low Back Pain: Resolving the Controversy, Increased Lumbar Lordosis and Smaller Vertebral Cross-Sectional Area Are Associated With Spondylolysis, Does Preoperative Degenerative Spondylolisthesis Influence Outcome in Degenerative Lumbar Spinal Stenosis? 30, No. 16, No. 2, Chiropractic & Manual Therapies, Vol. 7, Radiologic Clinics of North America, Vol. But it is most widely believed that the loss of a normal pattern of spinal motion causes pain and/or neurologic dysfunction. 11, 29 November 2011 | Clinical Orthopaedics and Related Research®, Vol. Journal of Korean Medicine Rehabilitation, Vol. 38, 1 December 2017 | Iranian Journal of Neurosurgery, Vol. 2005; 14: 743– 750. 84, No. 3. 11, Clinical Orthopaedics & Related Research, Vol. B App Sc (Phtyl. 2013, Advances in Bioscience and Biotechnology, Vol. lumbar fusion techniques in patients requiring surgery for spinal instability? 25, No. The influence of age, diagnosis, and procedure. This is a more complex procedure in relation to the simpel decompression preformed without instability for spinal stenosis. 46, No. 8, 1 December 2012 | Asian Journal of Sports Medicine, Vol. 9, Revue du Rhumatisme Monographies, Vol. 33, No. 18, Journal of Orthopaedic Translation, Vol. Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis. Which factors prognosticate spinal instability following lumbar laminectomy? 8, No. 27, No. 27, No. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username. Because of its simplicity, low expense, and pervasive availability, functional flexion-extension radiography is the most thoroughly studied and the most widely used method in the imaging diagnosis of lumbar intervertebral instability. 3, Radiología (English Edition), Vol. Radiol Clin North Am. 12, 1 November 2013 | RadioGraphics, Vol. 8, Musculoskeletal Science and Practice, Vol. Copyright © 2020 Elsevier B.V. or its licensors or contributors. Sequestrectomy With Additional Transpedicular Dynamic Stabilization for the Treatment of Lumbar Disc Herniation, Biomechanics of the spine. For cord abnormalities. 4, 26 March 2015 | Neuroradiology, Vol. Maigne, J., Lapeyre, E., Morvan, G. (2003) Pain immediately upon sitting down and relieved by standing is often associated with radiologic lumbar instability or marked anterior loss … 2, Rheumatic Disease Clinics of North America, Vol. This instability can be symptomatic or asymptomatic, depending on the demands made on the motion segment. 14, No. Seven patients (6%) developed lumbar instability, three patients (2%) developed new stenosis at an adjacent unoperated level, and three patients (2%) developed a new disc herniation between 2 and 5 years after surgery. 1, 6 November 2013 | Biomacromolecules, Vol. Instability of the lumbar spine, however, remains a controversial and poorly understood topic. 4, Journal of Korean Neurosurgical Society, Vol. 80, No. 11, No. 3, Journal of Korean Neurosurgical Society, Vol. 14, No. 1, Journal of Korean Neurosurgical Society, Vol. 1, International Orthopaedics, Vol. Cross-sectional study of 880 outpatients with low back and/or leg pain regarding age distribution of three radiologic factors. In spite of many efforts, a widely accepted definition of the condition has not been clearly established. Radiologic Procedure. The radiologic degree or severity of lumbar stenosis is typically described either qualitatively, as a percentage of narrowing, or quantitatively, by actual measurements in millimeters (mm). Lumbar instability occurred most often in the L 4–5 segment of patients with an average age of 41 ± 10.91 years. True synovial cysts of the lumbar spine: an epiphenomenon of instability of the functional spine unit? 2, Journal of Clinical Medicine, Vol. FJ Andrews. Age distribution of three radiologic factors for lumbar instability: probable aging process of the instability with disc degeneration. Radiology. Furthermore, since the cause of pain is biomechanical in nature, its treatment should be mechanical. Eur Spine J (2005) 14: 751 REVIEWER’S COMMENT DOI 10.1007/s00586-004-0828-8 Michael Pfeiffer Accuracy of the clinical examination to predict radiographic instability of the lumbar spine ROMs, could be expected.

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