The spine journal : official journal of the North American Spine Society
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Degenerative spondylolisthesis is a common pathologic condition that leads to lumbar instability and significant clinical symptoms. The effect of this pathology on adjacent lumbar motion segments, however, has not yet been studied. ⋯ There were a similar percentage of patients in each degenerative spondylolisthesis group with lumbar instability. Angular motion decreased at the diseased level with L3-L4 and L5-S1 spondylolisthesis, but increased with L4-L5 spondylolisthesis. Translational motion, however, increased at the diseased level in all three groups. There was compensatory hypermobility at adjacent levels in patients with unstable spondylolisthesis at L3-L4 and L4-L5, but not at L5-S1.
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Lateral spacers (LSs) are the standard of care for a lateral lumbar interbody fusion. However, various types of fixation, such as bilateral pedicle screws (BPSs), unilateral pedicle screws (UPSs), bilateral facet screws (BFSs), and lateral plates (LPs) have been reported to increase the stability of LSs. The biomechanics of a novel lateral interbody implant, which is an interbody spacer with an integrated plate and two bone screws (lateral integrated plate-spacer [IPS-L]), has not been investigated yet. ⋯ The IPS-L evaluated in the present study demonstrated equivalent biomechanical stability compared with standard lateral interbody fusion constructs. The addition of BPSs to the IPS-L showed significant reduction in ROM in FE, and the addition of BFSs showed significant reduction in ROM in FE and AR, compared with the integrated plate-spacer alone construct. The IPS-L with supplemental fixation may be a viable option for lateral interbody fusion. Long-term clinical studies are further required to confirm these results.
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Pain intensity in various chronic pain disorders has been associated with catastrophizing. Considering the pathomechanism and clinical symptoms of lumbar spinal stenosis (LSS), pain catastrophizing could be associated with pain intensity and disability in patients with LSS. ⋯ Pain catastrophizing was a mediator of gender differences for back pain and disability in patients with LSS. In addition, pain catastrophizing was associated with disability in LSS, which was partially mediated by increased back pain intensity.