ヤマウチ　カヅヨ   YAMAUCHI Kadzuyo   山内　かづ代    所属   医学部 医学科    職種   評議員
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Rotational hypermobility of disc wedging using kinematic CT: preliminary study to investigate the instability of discs in degenerated scoliosis in the lumbar spine.
掲載誌名	正式名：European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 略　 称：Eur Spine J ISSNコード：(1432-0932)0940-6719(Linking)
掲載区分	国外
巻・号・頁	19(6),pp.989-94
著者・共著者	Ohtori Seiji, Yamashita Masaomi, Inoue Gen, Yamauchi Kazuyo, Koshi Takana, Suzuki Munetaka, Takaso Masashi, Orita Sumihisa, Eguchi Yawara, Ochiai Nobuyasu, Kishida Shunji, Mimura Masaya, Yanagawa Noriyuki, Ishikawa Tetsuhiro, Arai Gen, Miyagi Masayuki, Kamoda Hiroto, Aoki Yasuchika, Kuniyoshi Kazuki, Nakamura Junichi, Takahashi Kazuhisa
発行年月	2010/06
概要	The number of patients showing lumbar degenerative scoliosis, including disc wedging, has increased, and examination of the mechanism of spinal nerve compression due to lateral and rotational mobility of the lumbar spine is necessary. Thirty-two patients with L4-L5 disc wedging but without antero- or retrospondylolisthesis and ten age-matched controls were examined. The angle of disc wedging and change in the angle between left and right bending were evaluated by anterior-posterior X-ray images of patients while they were in a standing position. The degree of disc degeneration and existence of vacuum phenomena were evaluated at the L4-L5 discs. Rotational mobility between maximal right and left rotation was examined by computed tomography (CT). Rotational mobility was measured using the spinal transverse processes of L4 and L5. The relationship between these factors was statistically evaluated using multivariate analysis and Spearman's correlation test. There was a significant increase in the average rotational mobility of the L4-L5 disc-wedging group. In the L4-L5 disc-wedging group, the increased angle of disc wedging and change in the angle between left and right bending correlated with increased rotational mobility. The degree of disc degeneration did not affect rotational mobility. However, existence of vacuum phenomena increased the rotational mobility of the L4-L5 disc-wedging group. This is the first study to evaluate the rotational hypermobility of L4-L5 disc wedging in patients without antero- or retrospondylolisthesis using kinematic CT. Increases in the wedging angle and abnormal instability of lateral bending correlated with increased rotational mobility. For surgical planning of degenerative L4-L5 disc wedging, it is important to consider rotational hypermobility using kinematic CT or X-ray imaging findings of lateral bending.
DOI	10.1007/s00586-010-1299-8
PMID	20140464