Abstract
The spine is a complex structure formed by motion segments (MSs) which, by working together, create a mobile, elastic and resistant ensemble, able to support the head and trunk and protect the spinal cord, the nerve roots and the vertebral arteries.
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References
White AA, Panjabi MM (1978) Clinical biomechanics of the spine. Lippincott, Philadelphia
Brinckmann P, Biggermann M, Hilweg D (1988) Fatigue fracture of human lumbar vertebrae. Clin Biomech 3(Suppl 1):S1–S23
Bogduk N (2012) Clinical and radiological anatomy of the lumbar spine, 5th edn. Churchill Livingstone Elsevier, Edinburgh, pp 61–71
Hansson TH, Keller TS, Spengler DM (1987) Mechanical behavior of the human lumbar spine. II. Fatigue strength during dynamic compressive loading. J Orthop Res 5:479–487
Adams MA, McNally DS, Wagstaff J et al (1993) Abnormal stress concentration in lumbar intervertebral discs following damage to the vertebral bodies: a cause of disc failure? Eur Spine J 1:214–221
Bogduk N (2012) Clinical and radiological anatomy of the lumbar spine, 5th edn. Churchill Livingstone Elsevier, Edinburgh, pp 173–196
Farfan HF, Kirkaldy-Willis WH (1981) The present status of spinal fusion in the treatment of lumbar intervertebral joint disorders. Clin Orthop 158:198–214
Bogduk N (1992) Sources of low back pain. In: Jayson MIV (ed) The lumbar spine and back pain. Churchill Livingstone, Edinburgh, pp 61–88
Bogduk N, Twomey L (1991) Clinical anatomy of the lumbar spine, 2nd edn. Churchill Livingstone, Melbourne
Ohshima H, Urban JPG (1992) The effect of lactate and pH on proteoglycan and protein synthesis rates in the intervertebral disc. Spine 17:1079–1082
Peng B, Chen J, Kuang Z, Li D et al (2009) Diagnosis and surgical treatment of back pain originating from endplate. Eur Spine J 18:1035–1040
Peng BG (2013) Pathophysiology, diagnosis, and treatment of discogenic low back pain. World J Orthop 4(2):42–52
Bogduk N (2012) Clinical and radiological anatomy of the lumbar spine, 5th edn. Churchill Livingstone Elsevier, Edinburgh, pp 11–27
Adams MA (2004) Biomechanics of back pain. Acupunct Med 22(4):178–188
Kuslich S, Ulstro C, Michael C (1991) The tissue origin of low back pain and sciatica. Orthop Clin North Am 22:181–187
Taylor JR (1990) The development and adult structure of lumbar intervertebral discs. J Man Med 5:43–47
Hickey DS, Hukins DWL (1980) X-ray diffraction studies of the arrangement of collagen fibres in human fetal intervertebral disc. J Anat 131:81–90
McNab I (1977) Backache. Williams and Wilkins, Baltimore, pp 4–7
Louis R (1989) Chirurgia del rachide. Piccin, Padova, pp 67–69
Dunlop RB, Adams MA, Hutton WC (1984) Disc space narrowing and the lumbar facet joints. J Bone Joint Surg Br 66:706–710
Bogduk N (2012) Clinical and radiological anatomy of the lumbar spine, 5th edn. Churchill Livingstone Elsevier, Edinburgh, pp 1–10
Pearcy M, Portek I, Sheperd J (1984) Three-dimensional X-ray analysis of normal movement in the lumbar spine. Spine 9:294–297
Boden SD, Riew DK, Yamaguchi K et al (1996) Orientation of the lumbar facet joints: association with degenerative disc disease. J Bone Joint Surg Am 78-A:403–411
Fujiwara A, Lim TH, An HS et al (2000) The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine 25(23):3036–3044
Shah JS (1980) Structure, morphology and mechanics of the lumbar spine. In: Jayson MIV (ed) The lumbar spine and backache, 2nd edn. Pitman, London, pp 359–405
Bogduk N (2012) Clinical and radiological anatomy of the lumbar spine, 5th edn. Churchill Livingstone Elsevier, Edinburgh, pp 207–215
Panjabi MM (1992) The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. J Spinal Disord 5:390–397
Kirkaldy-Willis WH (1985) Presidential symposium on instability of the lumbar spine. Introduction. Spine 10:254
White AA, Panjabi MM (1990) Clinical biomechanics of the spine, 2nd edn. JB Lippincott, Philadelphia
Larson SJ (1993) Vertebral injury and instability. In: Holtzman RMN (ed) Spinal instability. Springer, New York
Panjabi MM (1992) The stabilizing system of the spine. Part I. Function, dysfunction, adaptation and enhancement. J Spinal Disord 5:383–389
Pope MH, Panjabi M (1985) Biomechanical definitions of spinal instability. Spine 10:255–256
Akkerveeken PE, O’Brien JP, Parl WM (1979) Experimentally induced hypermobility in the lumbar spine: a pathologic and radiologic study of the posterior ligament and annulus fibrosus. Spine 4:236–241
Abumi K, Panjabi MM, Kramer KM et al (1990) Biomechanical evaluation of lumbar spinal stability after graded facetectomies. Spine 15:1142–1147
Panjabi MM (2003) Clinical spinal instability and low back pain. J Electromyogr Kinesiol 13:371–379
Panjabi MM (2006) A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction. Eur Spine J 15:668–676
Weiler PJ, King GJ, Gertzbein SD (1990) Analysis of sagittal plane instability of the lumbar spine in vivo. Spine 15:1300–1306
Scarfo’ GB (2002) Towards a functional definition of lumbar vertebral instability. Riv Neuroradiol 15:163–180
Harris R, Mcnab I (1954) Structural changes in the lumbar intervertebral discs their relationship to low back pain and sciatica. J Bone Joint Surg 36B:304–321
Harmon P (1964) Indications for spinal fusion in lumbar diskopathy, instability and arthrosis indications for spinal fusion in lumbar diskopathy, instability and arthrosis. I. Anatomic and functional pathology and review of literature. Clin Orthop Relat Res 34:73–91
Kirkaldy-Willis WH, Farfan HF (1982) Instability of the lumbar spine. Clin Orthop Relat Res 165:110–123
Jinkins JR (2004) Acquired degenerative changes of the intervertebral segments at and suprajacent to the lumbosacral junction. A radioanatomic analysis of the nondiscal structures of the spinal column and perispinal soft tissues. Eur J Radiol 50(2):134–158
O’Sullivan BP (2000) Lumbar segmental instability: clinical presentation and specific stabilizing exercise management. Man Ther 5:2–12
Park AL (2008) Instability: clinical manifestations and assessment. In: Slipman CW, Derby R, Simeone FA, Mayer TG (eds) Interventional spine an algorithmic approach. Saunders, Philadelphia, pp 1109–1119
Posner I, White AA, Edwards WI et al (1982) A biomechanical analysis of the clinical stability of the lumbar and lumbosacral spine. Spine 7:374–389
Boden SD, Wiesel SW (1990) Lumbosacral segmental motion in normal individuals. Have we been measuring instability properly? Spine 15:571–576
Hayes MA, Howard TC, Gruel CR et al (1989) Roentgenographic evaluation of lumbar spine flexion-extension in asymptomatic individuals. Spine 14:327–331
Lowe RW, Hayes TD, Kaye J et al (1976) Standing roentgenograms in spondylolisthesis. Clin Orthop 117:80–84
Pearcy M, Shepherd J (1985) Is there instability in spondylolisthesis? Spine 10:175–177
Axelsson P, Johnsson R, Stromqvist B (2000) Is there increased intervertebral mobility in isthmic adult spondylolisthesis? A matched comparative study using roentgen stereophotogrammetry. Spine 25:1701–1703
Matsunaga S, Ijiri K, Hayashi K (2000) Nonsurgically managed patients with degenerative spondylolisthesis: a 10- to 18-year follow-up study. J Neurosurg 93:194–198
Alyas F, Connell D, Saifuddin A (2008) Upright positional MRI of the lumbar spine. Clin Radiol 63:1035–1048
Weishaupt D, Schmid MR, Zanetti M (2000) Positional MR imaging of the lumbar spine: does it demonstrated nerve root compromise not visible a conventional MR imaging? Radiology 215:247–253
McGregor AH, Anderton L, Gedroyc WM et al (2002) The use of interventional open MRI to assess the kinematics of the lumbar spine in patients with spondylolisthesis. Spine 27(14):1582–1586
Niggemann P, Kuchta J, Beyer HK et al (2010) Spondylolysis and spondylolisthesis prevalence of different forms of instability and clinical implications. Spine 20:1–6
Murata M, Morio Y, Kuranobu K (1994) Lumbar disc de generation and segmental instability: a comparison of magnetic resonance images and plain radiographs of patients with low back pain. Arch Orthop Trauma Surg 113:297–301
Cartolari R (1997) Functional evaluation of the lumbar spine with axial-loaded computer tomography and cine ALCT. Riv Neuroradiol 10:569–584
Matsunaga S, Sakou T, Morizono Y et al (1990) Natural history of degenerative spondylolisthesis: pathogenesis and natural course of the slippage. Spine 15:1204–1210
Hioki A, Miyamoto K, Sakai H et al (2010) Lumbar axial loading device alters lumbar sagittal alignment differently from upright standing position: a computed tomography study. Spine 35(9):995–1001
Mulholland RC (2008) The myth of lumbar instability: the importance of abnormal loading as a cause of low back pain. Eur Spine J 17:619–625
McAfee P (1999) Interbody fusion cages in reconstructive operations on the spine. J Bone Joint Surg Am 83A:294–297
Schmoelz W, Huber JF, Nydegger T, Claes L, Wilke HJ (2006) Influence of a dynamic stabilisation system on load bearing of a bridged disc: an in vitro study of intradiscal pressure. Eur Spine J 15(8):1276–1285
Benzel EC (2003) Biomechanics of the spine. Thieme-Verlag, Stuttgart, pp 10–100
Bucholz RW, Gill K (1986) Classification of injuries to the thoracolumbar spine. Orthop Clin North Am 17:67–83
Whitesides TE (1977) Traumatic kyphosis of the thoracolumbar spine. Clin Orthop 128:78–92
Tran NT, Watson NA, Tencer AF et al (1984) Mechanism of the burst fracture in the thoracolumbar spine. Spine 20:1988–1995
Holdsworth FW (1963) Fracture, dislocation and fracture-dislocation of the spine. J Bone Joint Surg Br 45B:6–20
Denis F (1983) The three columns spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 8:817–831
Denis F (1984) Spinal instability as defined by the three-column spine concept in acute spinal trauma. Clin Orthop 189:65–76
Magerl F, Aebi M, Gertzbein SD et al (1994) A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 3:184–201
Leferink VJM, Veldhuis EFM, Zimmerman KW et al (2002) Classificational problems in ligamentary distraction type vertebral fractures: 30% of all B-type fractures are initially unrecognised. Eur Spine J 11:246–250
Lee HM, Kim HS, Kim DJ et al (2000) Reliability of magnetic resonance imaging in detecting posterior ligament complex injury in thoracolumbar spinal fractures. Spine 25(16):2079–2084
Starr JK, Hanley EN (1991) Junctional burst fractures. Spine 17:551–557
Sliker CW, Mirvis S, Shanmuganathan K et al (2005) Assessing cervical spine stability in obtunded blunt trauma patients: review of medical literature. Radiology 234(3):733–739
Williams RL, Hardman JA et al (1998) MR imaging of suspected acute spinal instability. Injury 29:109–113
Kirschner J, Seupaul RA (2012) Does computed tomography rule out clinically significant cervical spine injuries in patients with obtunded or intubated blunt trauma? Ann Emerg Med 60(6):737–738
Fine PR, Kuhlemeier KV, De Vivo MJ et al (1979) Spinal cord injury: an epidemiologic perspective. Paraplegia 17:237–250
Knopp R, Parker J, Tashjian J et al (2001) Defining radiographic criteria for flexion-extension studies of the cervical spine. Ann Emerg Med 38:31–35
Morris C, McCoy É (2004) Clearing the cervical spine in unconscious polytrauma victims, balancing risks and effective screening. Anaesthesia 59(5):464–482
Hogan GJ, Mirvis SE, Shanmuganathan K, Scalea TM et al (2005) Exclusion of unstable cervical spine injury in obtunded patients with blunt trauma: is MR imaging needed when multi–detector row CT findings are normal? Radiology 237(1):106–113
Panczykowski DM, Tomycz ND, Okonkwo DO (2011) Comparative effectiveness of using computed tomography alone to exclude cervical spine injuries in obtunded or intubated patients: meta-analysis of 14,327 patients with blunt trauma. J Neurosurg 115(3):541–549
Chang W, Alexander MT, Mirvis SE (2009) Diagnostic determinants of craniocervical distraction injury in adults. Am J Roentgenol 192(1):52–58
Rojas CA, Bertozzi JC, Martinez CR, Whitlow J et al (2007) Reassessment of the craniocervical junction: normal values on CT. Am J Neuroradiol 28(9):1819–1823
Vaccaro AR, Hulbert RJ, Patel AA et al (2007) The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex. Spine 32(21):2365–2374
Petersilge CA, Emery SE (1996) Thoracolumbar burst fracture: evaluating stability. Semin Ultrasound CT MR 17(2):105–113
Van der Roer N, de Lange ES, Bakker FC et al (2005) Management of traumatic thoracolumbar fractures: a systematic review of the literature. Eur Spine J 14:527–534
Knop C, Bastian L, Lange U et al (2002) Complications in surgical treatment of thoracolumbar injuries. Eur Spine J 11(3):214–226
McCormack T, Karaikovic E, Gaines RW (1994) The load sharing classification of spine fractures. Spine 19(15):1741–1744
Oner C, van der Rijt RR, Ramos LMP et al (1998) Changes in the disc space after fractures of thoracolumbar spine. J Bone Joint Surg Br 80:833–839
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Izzo, R., Guarnieri, G., Muto, M. (2015). Stability and Instability of the Spine. In: Manfrè, L. (eds) Spinal Instability. New Procedures in Spinal Interventional Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-12901-3_1
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DOI: https://doi.org/10.1007/978-3-319-12901-3_1
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