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Influence of the Amount of Slip in the Neutral Position and Sagittal Translation on Lumbar Symptoms Junya Akaura 1 , Tetsuhiro Iguchi 1 , Akira Kurihara 1 , Koichi Kasahara 1 , Aritetsu Kanemura 1 , Kyoko Yamasaki 1 , Keizo Sato 1 1Department of Orthopaedic Surgery, Kobe Rosai Hospital Keyword: lumbar spine , 腰椎 , degenerative spondylolisthesis , 変性すべり症 , vertebral translation , 椎体の前後動揺性 pp.501-507
Published Date 2003/4/1
DOI https://doi.org/10.11477/mf.1408100687
  • Abstract
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 Purpose:The purpose of this study was to assess the clinical significance of two radiologic factors, slip in neutral position and sagittal translation, in relation to lumbar symptoms.

 Methods:Between 1996 and 1997, 1,647 outpatients with low back disorders were examined radiologically. After excluding the 767 patients with trauma, compression fractures, spondylolysis and spondylolisthesis, scoliosis, retrolisthesis, or unsuitable radiographs, the radiographs of 880 patients were examined for amount of slip in the neutral position and sagittal translation at segment L4/5. The patients were divided into four groups according to whether a 3mm slip in neutral position and 3mm sagittal translation were detected. There were 32 patients with 3mm or more neutral slip and 3mm or more sagittal translation, 38 with 3mm or more neutral slip and less than 3mm sagittal translation, 106 with less than 3mm neutral slip and more than 3mm sagittal translation, and 704 with less than 3mm neutral slip and less than 3mm sagittal translation. The symptoms in the four groups were compared on the basis of their Japanese Orthopaedic Association lumbar scores.

 Results:The group with 3mm or more neutral slip was older than the other groups. The scores of the patients with 3mm or more neutral slip were significantly lower than those of the other groups, and symptom severity was not correlated with the amount of sagittal translation,indicating that a 3mm or more neutral slip had a greater impact on lumbar symptoms than sagittal translation. Sagittal translation, however, influenced symptoms when combined with 3mm or more neutral slip.

 Conclusion:Because of the elderly population with neutral slip, slip in the neutral position was concluded to be the final stage of disc degeneration. The slip in neutral position was a more important radiological factor than the sagittal translation on lumbar symptoms, therefore earlier intervention, such as by trunk-muscle exercise, should be recommended to patients with such evidence of disc degeneration in the minimal stage.


Copyright © 2003, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1286 印刷版ISSN 0557-0433 医学書院

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