title: The effect of standard lumbar discectomy on segmental motion: 5-year follow-up using radiostereometry.
abstract: We measured the effects of lumbar discectomy on segmental motion over a period of 5 years. Twenty-four patients with lumbar disc herniation were treated by standard lumbar discectomy at the L4-L5 or L5-S1 level. Peroperatively, tantalum markers were inserted into L4, L5, and the sacrum. Radiostereometric analysis was performed at discharge from hospital and 5 years postoperatively. The treated level was compared with the corresponding untreated level. Thus, patients who had discectomy at the L4-L5 level served as controls for patients with L5-S1 lesions and vice versa. The relative rotation and translation in relation to the three cardinal axes were calculated. Inducible displacements over the two discs were calculated between the supine and standing positions. At the L4-L5 level, there were no differences in inducible displacements between the operated and control levels at discharge or 5 years postoperatively. At the L5-S1 level we found decreasing inducible movement in the sagittal plane over time for discectomy patients. The reason for decreasing mobility over time after discectomy at the L5-S1 but not at the L4-L5 level is unknown. Mechanical factors caused by the more vertical orientation of the L5-S1 disc in combination with degenerative changes could be one explanation.
authors.affiliation: Department of Orthopaedics, Sahlgrenska University Hospital, 413 45, Göteborg, Sweden. klas.halldin@vgregion.se
authors.forename: K
authors.initials: K
authors.lastname: Halldin
authors.forename: B
authors.initials: B
authors.lastname: Zoëga
authors.forename: P
authors.initials: P
authors.lastname: Nyberg
authors.forename: J
authors.initials: J
authors.lastname: Kärrholm
authors.forename: B I
authors.initials: BI
authors.lastname: Lind
mesh_terms: D000328:Adult; D017586:Diskectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular
references.citation: Acta Orthop Scand. 1989 Aug;60(4):491-503
references.pmid: 2683567
references.citation: J Biomech. 2002 Jan;35(1):69-79
references.pmid: 11747885
references.citation: Spine (Phila Pa 1976). 1990 May;15(5):347-50
references.pmid: 2363063
references.citation: Spine (Phila Pa 1976). 1998 Dec 1;23(23):2648-55
references.pmid: 9854765
references.citation: Spine (Phila Pa 1976). 1997 Dec 15;22(24):2968-76
references.pmid: 9431634
references.citation: Spine (Phila Pa 1976). 1980 Mar-Apr;5(2):133-42
references.pmid: 6446158
references.citation: Clin Biomech (Bristol, Avon). 1997;12 Suppl 1:S1-S63
references.pmid: 11430783
references.citation: Clin Orthop Relat Res. 1982 May;(165):110-23
references.pmid: 6210480
references.citation: Spine (Phila Pa 1976). 1985 Jun;10(5):455-60
references.pmid: 4049113
references.citation: Clin Biomech (Bristol, Avon). 1996 Dec;11(8):457-465
references.pmid: 11415660
references.citation: J Neurosurg. 2000 Jul;93(1 Suppl):58-64
references.pmid: 10879759
references.citation: Clin Orthop Relat Res. 1966 Mar-Apr;45:107-22
references.pmid: 5937361
references.citation: Clin Orthop Relat Res. 1990 Jul;(256):147-61
references.pmid: 2364604
references.citation: Med Biol Eng Comput. 1980 Sep;18(5):694-700
references.pmid: 6450859
references.citation: Spine (Phila Pa 1976). 1999 Jul 1;24(13):1277-82
references.pmid: 10404567
references.citation: Spine (Phila Pa 1976). 1985 Jul-Aug;10(6):543-54
references.pmid: 4081869