Analysis on risk factor for lumbar disc herniation after decompression / 局解手术学杂志

Objective The study aimed to identify risk factors of lumbar disc herniation in patients after decompression,and provide theoretical basis for postoperaive rehabilitation.Methods A told of 169 patients with lumbar spinal stenosis underwent bilateral partial laminectomy were included in the study,24 patients in herniation group,and 145 patients without develop postoperative acute sciatica as a control group.The radiographic variables were measured.The threshold of risk factors was evaluated by multiple logistics analysis and receiver operating characteristic curve(ROC) analysis.Results The results revealed that preoperative retrolisthesis during extension was the independent risk factor for lumbar disc herniation(1.24,95％CI[1.07～1.43];P<0.01).The area under the curve(AUC) was 0.801,and the cutoff value was 6.89％.Conclusion The preoperative retrolisthesis was the risk factor of lumbar disc herniation.

Retrolisthesis as a Compensatory Mechanism in Degenerative Lumbar Spine

OBJECTIVE: Posterior vertebral translation as a type of spondylolisthesis, retrolisthesis is observed commonly in patients with degenerative spinal problems. Nevertheless, there is insufficient literature on retrolisthesis compared to anterolisthesis. The purpose of this study is to clarify the clinical features of retrolisthesis, and its developmental mechanism associated with a compensatory role in sagittal imbalance of the lumbar spine. METHODS: From 2003 to 2012, 230 Korean patients who underwent spinal surgery in our department under the impression of degenerative lumbar spinal disease were enrolled. All participants were divided into four groups : 35 patients with retrolisthesis (group R), 32 patients with simultaneous retrolisthesis and anterolisthesis (group R+A), 76 patients with anterolisthesis (group A), and 87 patients with non-translation (group N). The clinical features and the sagittal parameters related to retrolisthesis were retrospectively analyzed based on the patients' medical records. RESULTS: There were different clinical features and developmental mechanisms between retrolisthesis and anterolisthesis. The location of retrolisthesis was affected by the presence of simultaneous anterolisthesis, even though it predominantly manifest in L3. The relative lower pelvic incidence, pelvic tilt, and lumbar lordosis compared to anterolisthesis were related to the generation of retrolisthesis, with the opposite observations of patients with anterolisthesis. CONCLUSION: Retrolisthesis acts as a compensatory mechanism for moving the gravity axis posteriorly for sagittal imbalance in the lumbar spine under low pelvic incidence and insufficient intra-spinal compensation.

Radiological and Clinical Analysis of Degenerative Lumbar Retrolisthesis: Comparative Study of Degenerative Spondylolisthesis / 대한척추외과학회지

STUDY DESIGN: This is a retrospective study. OBJECTIVES: We wanted to analyze the radiological features of degenerative lumbar spondylolisthesis and retrolisthesis, and we wanted to verify what radiological factors are related to the development of the retrolisthesis. We also wanted to determine these radiological factors' clinical significance. SUMMARY OF THE LITERATURE REVIEW: There is little information about the pathological mechanism and the clinical and radiological aspects of degenerative lumbar retrolisthsis. MATERIALS & METHODS: Sixty patients were reviewed and divided into three groups. The degenerative lumbar retrolisthesis patients were in group A. The degenerative lumbar spondylolisthesis patients were in group B. Group C patients had no vertebral shift in any direction. The factors we measured were the facet joint angle, the disc height of L3-4, L4-5 and L5-S1, and the lordosis of the lumbar spine. The evaluation of the clinical results was then quantified. RESULTS: The facet joint angle showed no statistical significance between the two groups. The disc height of group A at L4-5 and L5-S1 was more decreased in group A than in group B (p<0.05). Lumbar lordosis was decreased significantly in group A (p<0.05). The preoperative pain was improved at the final follow up, but preoperative pain was significantly higher in group A than in group B (p<0.05). The clinical results were improved in each group, but there was no statistically significant difference between the two groups. CONCLUSIONS: The disc height and lumbar lordosis were considerably reduced in the patients with retrolisthesis, especially compared to those patients with spondylolisthesis. Preoperative pain was higher for the retrolisthesis patients than for the spondylolithesis patients, but there was no significant difference.

Lumbar synovial cyst associated with retrolis thesis: a case report / 영남의대학술지

In advent of high-resolutional CT and MRI, it is not so difficult to detect the lumbar synovial cyst, however the unusual disease should be included in the differential diagnosis of cauda equine compression syndromes. The case of a 55-year-old man who had a low back pain and severe radiating pain on both legs showed a retrolisthesis at L3-4 and L4-5 and epidural enhancing mass just around L4-5 facet joint on MRI. Microscopically a lining of synovial tissue was demonstrated. After surgery of the total resection of synovial cyst and stabilization, the patient's presenting symptoms were improved.