The Change of Motion Ranges of Adjacent Vertebral Joints after Lumbar Fusion Operation

요추 고정수술 후 인접척추 운동범위의 변화

  • Yeo, Sang-Jun (Department of Neurosurgery, Chung-Ang Medical University) ;
  • Park, Seung-Won (Department of Neurosurgery, Chung-Ang Medical University) ;
  • Kim, Young-Baeg (Department of Neurosurgery, Chung-Ang Medical University) ;
  • Hwang, Sung-Nam (Department of Neurosurgery, Chung-Ang Medical University) ;
  • Choi, Duck-Young (Department of Neurosurgery, Chung-Ang Medical University) ;
  • Suk, Jong-Sik (Department of Neurosurgery, Chung-Ang Medical University) ;
  • Chung, Dong-Kue (Department of Neurosurgery, Chung-Ang Medical University) ;
  • Min, Byung-Kook (Department of Neurosurgery, Chung-Ang Medical University)
  • 여상준 (중앙대학교 의과대학 신경외과학교실) ;
  • 박승원 (중앙대학교 의과대학 신경외과학교실) ;
  • 김영백 (중앙대학교 의과대학 신경외과학교실) ;
  • 황성남 (중앙대학교 의과대학 신경외과학교실) ;
  • 최덕영 (중앙대학교 의과대학 신경외과학교실) ;
  • 석종식 (중앙대학교 의과대학 신경외과학교실) ;
  • 정동규 (중앙대학교 의과대학 신경외과학교실) ;
  • 민병국 (중앙대학교 의과대학 신경외과학교실)
  • Received : 2000.04.26
  • Accepted : 2000.09.18
  • Published : 2000.11.28

Abstract

Objectives : Transpedicular screw fixation has become an important method for internal fixation in variety of disorders. However, acceleration of degeneration at the adjacent segment in any follow. The goal of this study is to review the change of motion ranges of vertebral joints adjacent to fused level in lumbar spine. Methods : This study consists of 22 patients with degenerative spinal instability. Treatment of spinal instability includes posterior fusion with transpedicular screw fixation or transpedicular screw fixation with posterior lumbar interbody fusion. The flexion-extension angle(FEA) was measured from dynamic views of lumbar spine taken both at preoperative and post operative period. Results : The FEA of upper vertebral joint adjacent(FEA-u) to a fused L4-5 level was increased(p=0.010). The FEA-u was increased in case of L5-S1 fusion(p=0.025). The change of FEA-u in case of L5-S1 fusion was greater than that in L4-5 fusion(p=0.013). Conclusion : After L4-5 fusion, there seems to be more meaningful increase in FEA of L3-4 than that of L5-S1. The reason may be due to the damage of L3-4 facet joints during the operation, the other possible explanation may be the anatomical stability of L5-S1 vertebral joint. The change of FEA-u of L5-S1 fusion is increased more than that of L4-5 fusion. Because there are compensations in the adjacent vertebrae both above and below the fused L4-5, the compensatory motion in FEA-u of L5-S1 fusion was greater than that of the L4-5 fusion.

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