PM&R
Volume 1, Issue 6 , Pages 541-546 , June 2009

Changes in Posterior Lumbar Disk Contour Abnormality with Flexion-Extension Movement in Subjects with Low Back Pain and Degenerative Disk Disease

  • Shi-Uk Lee, MD

      Affiliations

    • Seoul National University, College of Medicine, Boramae Medical Center, Department of Physical Medicine and Rehabilitation, Seoul, Korea†
    • ,
  • Jong-In Lee, MD, PhD

      Affiliations

    • Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea‡
    • ,
  • Kim Butts, PhD

      Affiliations

    • Department of Radiology, Stanford University School of Medicine, Stanford, CA§
    • ,
  • Eugene Carragee, MD

      Affiliations

    • Spine Center, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA
    • ,
  • Michael Fredericson, MD

      Affiliations

    • Division of Physical Medicine & Rehabilitation, Department of Orthopaedic Surgery, Stanford University School of Medicine, 450 Broadway St, Redwood City, CA 94063∥
    • Corresponding Author InformationAddress correspondence to: M.F.

Received 12 September 2008 ,Accepted 29 March 2009.

References 

  1. McKenzie RA. The Lumbar Spine: Mechanical Diagnosis and Therapy. Wellington, New Zealand: Spinal Publications; 1981;
  2. Bogduk N, Jull G. The theoretical pathology of acute locked back: A basis for manipulative therapy. Manu Med. 1985;1:78–82
  3. Cyriax HJ, Cyriax PJ. Illustrated Manual of Orthopaedic Medicine. Oxford, UK: Butterworth Heineman; 1993;
  4. Gertzbein SD, Seligman J, Holtby R, et al. Centrode patterns and segmental instability in degenerative disc disease. Spine. 1985;10:257–261
  5. Kirkaldy-Willis WH, Farfan HF. Instability of the lumbar spine. Clin Orthop. 1982;165:110–123
  6. Fredericson M, Lee SU, Welsh J, Butts K, Norbash A, Carragee E. Changes in posterior disc bulging and intervertebral foraminal size associated with flexion-extension movement: A comparison between L4-L5 and L5-S1 levels in normal subjects. Spine J. 2001;1:10–17
  7. Zamani AA, Moriarty T, Hsu L, et al. Functional MRI of the lumbar spine in erect position in a superconducting open-configuration MR system: Preliminary results. J Magn Reson Imaging. 1998;8:1329–1333
  8. Schnebel BD, Watkins RG, Dillin W. The role of spinal flexion-extension in changing nerve root compression in disc herniations. Spine. 1989;14:835–837
  9. Edmondston SJ, Song S, Bricknell RV, et al. MRI evaluation of lumbar spine flexion and extension in asymptomatic individuals. Man Ther. 2000;5:158–164
  10. Weishaupt D, Schmid MR, Zanetti M, et al. Positional MR imaging of the lumbar spine: Does it demonstrate nerve root compromise not visible at conventional MR imaging?. Radiology. 2000;215:247–253
  11. Tanaka N, An H, Lim T, Fujiwara A, Jeon C, Haughton VM. The relationship between disc degeneration and flexibility of the lumbar spine. Spine J. 2001;1:47–56
  12. Kuslich SD, Ulstrom CL, Michael CJ. The tissue origin of low back pain and sciatica: A report of pain response to tissue stimulation during operations on the lumbar spine using local anesthesia. Orthop Clin North Am. 1991;22:181–187
  13. Smyth MJ, Wright V. Sciatica and the intervertebral disc. J Bone Joint Surg Am. 1958;40:1401–1418
  14. Fagerlund MK, Thelander U, Friberg S. Size of lumbar disc hernias measured using computed tomography and related to sciatic symptoms. Acta Radiol. 1990;31:555–558
  15. Komori H, Shinomiya K, Nakai O, Yamaura I, Takeda S, Furuya K. The natural history of herniated nucleus pulposus with radiculopathy. Spine. 1996;21:225–229
  16. Luoma K, Riihimäki H, Luukkonen R, Raininko R, Viikari-Juntura E, Lamminen A. Low back pain in relation to lumbar disc degeneration. Spine. 2000;25:487–492
  17. Parent EC, Videman T, Battié MC. The effect of lumbar flexion and extension on disc contour abnormality measured quantitatively on magnetic resonance imaging. Spine. 2006;31:2836–2842
  18. Wildermuth S, Zanetti M, Duewell S, et al. Lumbar spine: Quantitative and qualitative assessment of positional (upright flexion and extension) MR imaging and myelography. Radiology. 1998;207:391–398
  19. Reitman CA, Hipp JA, Kirking BC, Haas S, Esses SI. Posterior annular strains during discography. J Spinal Disord. 2001;14:347–352
  20. Choy DS. Magnetic resonance imaging of the lumbosacral spine under compression. J Clin Laser Med Surg. 1997;15:71–73
  21. Yu S, Haughton VM, Sether LA, Wagner M. Anulus fibrosus in bulging intervertebral disks. Radiology. 1988;169:761–763
  22. Zhao F, Pollintine P, Hole BD, Dolan P, Adams MA. Discogenic origins of spinal instability. Spine. 2005;30:2621–2630
  23. Adams MA, May S, Freeman BJC, Morrison HP, Dolan P. Effects of backward bending on lumbar intervertebral discs: Relevance to physical therapy treatments for low back pain. Spine. 2000;25:431–443
  24. Kramer MS, Leinstein AR. The biostatistics of concordance. Clin Pharmacol Ther. 1981;29:111–123
  25. Khan KS, Chen PFW. Evaluation of a clinical test (I: Assessment of reliability). Br J Obstet Gynaecol. 2001;108:562–567
  26. Vanharanta H, Sachs BL, Spivey MA, et al. The relationship of pain provocation to lumbar disc deterioration as seen by CT/discography. Spine. 1987;12:295–298
  27. Moneta GB, Videman T, Kaivanto K, et al. Reported pain during lumbar discography as a function of anular ruptures and disc degeneration (A re-analysis of 833 discograms). Spine. 1994;19:1968–1974
  28. Boos N, Rieder R, Schade V, Spratt KF, Semmer N, Aebi M. 1995 Volvo Award in clinical sciences (The diagnostic accuracy of magnetic resonance imaging, work perception, and psychosocial factors in identifying symptomatic disc herniations). Spine. 1995;20:2613–2625
  29. Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic resonance scans of the lumbar spine in asymptomatic subjects (A prospective investigation). J Bone Joint Surg Am. 1990;72:403–408
  30. Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331:69–73
  31. Hitselberger WE, Witten RM. Abnormal myelograms in asymptomatic patients. J Neurosurg. 1968;28:204–206
  32. Holt EP. The question of lumbar discography. J Bone Joint Surg Am. 1968;50:720–726
  33. Wiesel SW, Tsourmas N, Feffer HL, Citrin CM, Patronas N. A study of computer-assisted tomography (I. The incidence of positive CAT scans in an asymptomatic group of patients). Spine. 1984;9:549–551
  34. Lowell AS, Nguyen C, Yu S. Canine intervertebral disks: correlation of anatomy and MR imaging. Radiology. 1990;175:207–211

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

PII: S1934-1482(09)00381-5

doi: 10.1016/j.pmrj.2009.03.014

PM&R
Volume 1, Issue 6 , Pages 541-546 , June 2009

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