title: [Adjacent segment movement after monosegmental total disc replacement and monosegmental fusion of segments L4/5].
abstract: BACKGROUND
  Preservation of movement at the treated segment and possible reduction of adjacent segment effects is assumed to be an advantage of non-fusion technologies over fusion. The aim of this study was to compare the segmental range of motion (ROM) at the operative level, the cranial and caudal adjacent levels and the global lumbar spine ROM (L2-S1) after monosegmental fusion and total disc replacement (TDR).
  
  
  METHODS
  Radiographic data was collected from 27 patients with level 1 degenerative disc disease operated at level L4/5. The ROM was assessed at the index level (L4/5), the cranial and caudal adjacent level and for the lumbar spine (L2-S1).
  
  
  RESULTS
  In the TDR group no significant changes of lumbar spine ROM (L2-S1) and segmental ROM (index level, cranial and caudal adjacent level) were noticed. In the fusion group there was a significant reduction of lumbar ROM (L2-S1) and index level ROM. Additionally the relative ROM in the adjacent caudal segment significantly increased while no changes were seen in the cranial segment.
  
  
  CONCLUSIONS
  The relative ROM was significantly increased in monosegmental fusion at level L4/5 compared to TDR. To what extent this fact may result in early adjacent segment degeneration in cases of fusion compared to TDR is still unknown.
authors: Orthopädische Universitätsklinik Ulm am RKU, RKU - Universitäts- und Rehabilitationskliniken Ulm gGmbH, Oberer Eselsberg 45, 89081 Ulm, Deutschland. manuel-daexle@gmx.de
authors: M
authors: M
authors: Däxle
authors: T
authors: T
authors: Kocak
authors: F
authors: F
authors: Lattig
authors: H
authors: H
authors: Reichel
authors: B
authors: B
authors: Cakir
mesh_terms: D000328:Adult; D001175:Arthrography; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D013123:Spinal Fusion / Q000009:adverse effects*; D059145:Total Disc Replacement / Q000009:adverse effects*; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000601:surgery*
references: Spine (Phila Pa 1976). 2004 Sep 1;29(17):1938-44
references: 15534420
references: Spine (Phila Pa 1976). 2003 Oct 15;28(20):S110-7
references: 14560182
references: J Bone Joint Surg Br. 2002 Mar;84(2):289-94
references: 11922374
references: Eur Spine J. 2006 Feb;15(2):165-73
references: 16151712
references: Spine (Phila Pa 1976). 1996 Apr 15;21(8):970-81
references: 8726202
references: Spine (Phila Pa 1976). 2007 Mar 15;32(6):661-6
references: 17413471
references: J Spinal Disord Tech. 2005 Aug;18(4):353-9
references: 16021017
references: Clin Biomech (Bristol, Avon). 2007 Mar;22(3):257-65
references: 17196720
references: J Neurosurg Spine. 2007 Aug;7(2):131-8
references: 17688051
references: Spine (Phila Pa 1976). 2004 Jul 15;29(14):1535-40
references: 15247575
references: Bull NYU Hosp Jt Dis. 2007;65(1):29-36
references: 17539759
references: Spine (Phila Pa 1976). 1997 Nov 15;22(22):2655-63
references: 9399452
references: Spine (Phila Pa 1976). 2006 May 1;31(10):E291-7
references: 16648735
references: Spine (Phila Pa 1976). 1998 Jul 15;23(14):1550-8
references: 9682311
references: Spine (Phila Pa 1976). 2005 Jul 15;30(14):1565-75; discussion E387-91
references: 16025024
references: Spine (Phila Pa 1976). 2008 Jul 1;33(15):1701-7
references: 18594464
references: Clin Biomech (Bristol, Avon). 2005 May;20(4):357-64
references: 15737442
references: Spine (Phila Pa 1976). 2007 Sep 15;32(20):2253-7
references: 17873819
references: Spine (Phila Pa 1976). 2007 Apr 20;32(9):959-66; discussion 967
references: 17450069
references: Spine (Phila Pa 1976). 2009 May 20;34(12):1287-91
references: 19455004
references: Spine (Phila Pa 1976). 2008 Nov 1;33(23):2510-7
references: 18978591
references: Spine (Phila Pa 1976). 2007 May 15;32(11):1155-62; discussion 1163
references: 17495770
references: Spine (Phila Pa 1976). 2005 Jun 15;30(12):1407-11
references: 15959370
references: J Neurosurg Spine. 2008 Jan;8(1):7-12
references: 18173340
references: Spine (Phila Pa 1976). 1995 Mar 1;20(5):526-31
references: 7604320
references: J Bone Joint Surg Am. 2004 Jul;86(7):1497-503
references: 15252099