DOI: https://doi.org/10.15674/0030-59872018196-104

New classification 3 columns theory of lumbar degenerative cascade (literature review)

Bambang Darwono, Volodymyr Radchenko

Abstract


Lumbar degeneration is a pathologic condition in the aging spine that changes the bio-mechanic construct of the lumbar mobile segment either single or multi-levels, leading to low back pain syndrome and lead to a deformity/de novo scoliosis. The generally well accepted theory of lumbar degeneration was published by Kirkaldy-Willis, et all (1978), and clearly described the pathologic cascade of lumbar mobile segment, but only involve 2 columns: the anterior column (disc) and middle column (posterior joint/ facet). The posterior column degenerative cascade was published by Christian Ingerslev Baastrup (1933). He described about the pathologic changes on spinous processes of lumbar vertebrae and the soft tissues in between them, which was then known as Baastrup’s disease or Kissing Spine. Lacking off to understand the etiology due to a limitation of studies in histologic and radiographic changes at that time, then this theory was forgotten in the clinical practice until the recent Bristol and Auckland study, which were published in European Spine Journal (2012). Their study describes clearly the pathologic cascade of the posterior column that contributing the lumbar degeneration. Based on this 3 columns theory of lumbar degenerative cascade, then a new classification is designed to describe detail of bio-mechanic change in the anterior, middle and posterior column leading to low back pain syndrome and deformity. The justification of surgical treatment to fix and reconstruct the bio-mechanic changes of the 3 columns of lumbar mobile segment could be based on this new classification.


Keywords


lumbar degeneration; spine; theory of cascade

References


Aylott, C. E., Puna, R., Robertson, P.A., & Walker, C. (2012). Spinous process morphology: the effect of ageing through adulthood on spinous process size and relationship to sagittal alignment. European Spine Journal, 21(5),1007–1012. doi: 10.1007/s00586-011-2029-6

Baastrup, I. (1933). On the Spinous Processes of the Lumbar Vertebrae and the Soft Tissues between Them, and on Pathological Changes in That Region. Acta Radiologica, Original Series, 14(1), 52-55. doi:10.1177/028418513301400106

Barrick, W. T., Schofferman, J. A., Reynolds, J. B., Goldthwaite, N. D., McKeehen, M., Keaney, D., & White, A. H. (2000). Anterior lumbar fusion improves discogenic pain at levels of prior posterolateral fusion. Spine, 25(7), 853-857. doi:10.1097/00007632-200004010-00014

Bono, C. M., Bawa, M., & White, K. (2003). How much radiographic motion is present after solid fusion, Annual Meeting of the International Society for the Study of the Lumbar Spine. Vancouver, BC.

Brantigan, J. W., Steffee, A. D., Lewis, M. L., Quinn, L. M., & Persenaire, J. M. (2000). Lumbar Interbody Fusion Using the Brantigan I/F Cage for Posterior Lumbar Interbody Fusion and the Variable Pedicle Screw Placement System. Spine, 25(11), 1437-1446. doi:10.1097/00007632-200006010-00017

Darwono, B. (2012). The role of IntraSpine in the treatment of late degenerative problems, COA 2012 Meeting. Beijing, 2012.

Darwono, B. (2013). The role of interlaminar (IntraSpine) in the treatment of early and late degenerative problems, IntraSpine Users Meeting, Nice, France, 2013.

Darwono, B. (2013). The role of interlaminar (IntraSpine) device in the treatment of early & late degenerative problems, ISMISS, Turkey, 2013.

Darwono, B. (2013). The role of new interlaminar device (IntraSPINE) in the treatment of early & late degenerative problems, Indonesian Spine Society Meeting, Palembang, Indonesia, 2013.

Darwono, B. (2013). The role of interlaminar stabilization device (IntraSPINE) in the treatment of early & late degenerative problems, 13th Annual Meeting PASMISS, Miyazaki, Japan, 2013.

DePalma, A. F., & Rothman, R. H. (1969). Surgery of the Lumbar Spine. Clinical Orthopaedics and Related Research, 1(63), 162-170. doi:10.1097/00003086-196903000-00016

Eck, J. C., Humphreys, S. C., & Hodges, S. D. (1999). Adjacent-segment degeneration after lumbar fusion. A review of clinical, biomechanical, and radiologic studies. American journal of orthopedics, 28, 336–340.

Etebar, S., & Cahill, D. W. (1999). Risk factors for adjacent-segment failure following lumbar fixation with rigid instrumentation for degenerative instability. Journal of Neurosurgery: Spine, 90(2), 163-169. doi:10.3171/spi.1999.90.2.0163

Frymoyer, J. W., & Krag, M. H. (1986). Spinal stability and instability: Definitions, classification, and general priciples of management. In A. Kahn (Ed.), The Unstable Spine, New York: Grune & Stratton.

Frymoyer, J. W., Selby, D. K. (1985). Segmental Instability. Spine, 10(3), 280-286. doi:10.1097/00007632-198504000-00017

Fujiwara, A., Lim, T., An, H. S., Tanaka, N., Jeon, C., Andersson, G. B., & Haughton, V. M. (2000). The Effect of Disc Degeneration and Facet Joint Osteoarthritis on the Segmental Flexibility of the Lumbar Spine. Spine, 25(23), 3036-3044. doi:10.1097/00007632-200012010-00011

Fujiwara, A., Tamai, K., An, H. S., Kurihashi, A., Lim, T., Yoshida, H., & Saotome, K. (2000). The Relationship Between Disc Degeneration, Facet Joint Osteoarthritis, and Stability of the Degenerative Lumbar Spine. Journal of Spinal Disorders, 13(5), 444-450. doi:10.1097/00002517-200010000-00013

Guizzardi, G., & Petrini, P. (2007). DIAM Spinal Stabilization System. In Motion preservation surgery of the spine, Advanced technique and controversies (pp. 519–522). Saunders Elsevier.

Guizzardi, G., Morichi, R., & Mattioli, C. M. (2008). Italian Multicentre study on the use of A New Interlaminar Prosthesis (INTRASPINE) in DDD of the lumbar spine: Preliminary Report, Deutscher Wierbelsaulenkongress. Congress Centrum, Ulm, 27–29 november, 2008.

Guizzardi, G., & Petrini, P. Interspinous versus Interlaminar devices in DDD: Biomechanic Tests, Deutscher Wierbelsaulenkongress, Internationales Congress Centrum. Munchen, 10–12 december, 2009.

Jinkins, J. R. (2001). Acquired Degenerative Changes Of The Intervertebral Segments At And Suprajacent To The Lumbosacral Junction. Radiologic Clinics of North America, 39(1), 73-99. doi:10.1016/s0033-8389(05)70264-5

Kanayama, M., Hashimoto, T., Shigenobu, K., Harada, M., Oha, F., Ohkoshi, Y., … Yamane, S. (2001). Adjacent-segment morbidity after Graf ligamentoplasty compared with posterolateral lumbar fusion. Journal of Neurosurgery: Spine, 95(1), 5-10. doi:10.3171/spi.2001.95.1.0005

Kanayama, M., Hashimoto, T., Shigenobu, K., Oha, F., Ishida, T., & Yamane, S. (2005). Non-Fusion Surgery for Degenerative Spondylolisthesis Using Artificial Ligament Stabilization. Spine, 30(5), 588-592. doi:10.1097/01.brs.0000154766.74637.5e

KCE Reports, Spinal Dynamic Stabilization Implants, Bruxelles, 29 october, 2009.

Keller, T. S., Hansson, T. H., Abram, A. C., Spengler, D. M., & Panjabi, M. M. (1989). Regional Variations in the Compressive Properties of Lumbar Vertebral Trabeculae. Spine, 14(9), 1012-1019. doi:10.1097/00007632-198909000-00016

Kirkaldy-Willis, W. H., Wedge, J. H., Yong-Hing, K., & Reilly, J. (1978). Pathology and Pathogenesis of Lumbar Spondylosis and Stenosis. Spine, 3(4), 319-328. doi:10.1097/00007632-197812000-00004

Kwong, Y., Rao, N., & Latief, K. (2011). MDCT Findings in Baastrup Disease: Disease or Normal Feature of the Aging Spine? American Journal of Roentgenology, 196(5), 1156-1159. doi:10.2214/ajr.10.5719

Lee, C. K. (1988). Accelerated Degeneration of the Segment Adjacent to a Lumbar Fusion. Spine, 13(3), 375-377. doi:10.1097/00007632-198803000-00029

Lindsey, D. P., Swanson, K. E., Fuchs, P., Hsu, K. Y., Zucherman, J. F., & Yerby, S. A. (2003). The Effects of an Interspinous Implant on the Kinematics of the Instrumented and Adjacent Levels in the Lumbar Spine. Spine, 28(19), 2192-2197. doi:10.1097/01.brs.0000084877.88192.8e

McAfee, P. C., Cunningham, B. W., Devine, J., Williams, E., & Yu-Yahiro, J. (2003). Classification of Heterotopic Ossification (HO) in Artificial Disk Replacement. Spine, 28, 384-389. doi:10.1097/00007632-200300001-00010

Molz, F., Partin, J., & Kirkpatrick, J. (2003). The acute effect of L3/L4 fusion on the motionof vertebrae in a whole lumbar cadaveric spine, Annual Meeting of the International Society for the Study of the Lumbar Spine. Vancouver, BC

Moore, R. J., Vernon-Roberts, B., Fraser, R. D., Osti, O. L., & Schembri, M. (1996). The Origin and Fate of Herniated Lumbar Intervertebral Disc Tissue. Spine, 21(18), 2149-2155. doi:10.1097/00007632-199609150-00018

Mulholland, R. C., & Sengupta, D. K. (2004). Rationale, principles and experimental evaluation of the concept of soft stabilization. Arthroplasty of the Spine, 142-149. doi:10.1007/978-3-642-18508-3_22

Okawa, A., Shinomiya, K., Komori, H., Muneta, T., Arai, Y., & Nakai, O. (1998). Dynamic Motion Study of the Whole Lumbar Spine by Videofluoroscopy. Spine, 23(16), 1743-1749. doi:10.1097/00007632-199808150-00007

Paajanen, H., & Tertti, M. (1991). Association of incipient disc degeneration and instability in spondylolisthesis. Archives of Orthopaedic and Trauma Surgery, 111(1), 16-19. doi:10.1007/bf00390186

Parker, L. M., Murrell, S. E., Boden, S. D., & Horton, W. C. (1996). The Outcome of Posterolateral Fusion in Highly Selected Patients With Discogenic Low Back Pain. Spine, 21(16), 1909-1916. doi:10.1097/00007632-199608150-00016

Patel, C., Truumees, E., & Gittlin, J. (2002). Symptomatic spinal stenosis adjacent to a previous lumbar fusion. Spine Journal, 2(Suppl),54S–55S

Pearcy, M. J., & Tibrewal, S. B. (1984). Lumbar Intervertebral Disc and Ligament Deformations Measured In Vivo. Clinical Orthopaedics and Related Research, &NA;(191), 281–286. doi:10.1097/00003086-198412000-00038

Putzier, M., Schneider, S. V., Funk, J. F., Tohtz, S. W., & Perka, C. (2005). The Surgical Treatment of the Lumbar Disc Prolapse. Spine, 30(5), E109-E114. doi:10.1097/01.brs.0000154630.79887.ef

Rauschning, W. (2013).Department of Orthopaedic Surgery Academic University Hospital, SE-75185 UPPSALA, Sweden, Personal Communication.

Roy-Camille, R., Saillant, G, & Massin P. (1989). Traitement des fractures du rachis dorsolombaire par la method de Bohler. Revue De Chirurgie Orthopedique Et Reparatrice De L'Appareil Moteur, 75(7), 479–489.

Schechter, N. A., France, M. P., & Lee, C. K. (1991). Painful internal disc derangements of the lumbosacral spine: Discographic diagnosis and treatment by posterior lumbal interbody fusion. Orthopaedics, 14(4), 447–451.

Seligman, J. V., Gertzbein, S. D., Tile, M., & Kapasouri, A. (1984). Computer Analysis of Spinal Segment Motion in Degenerative Disc Disease With and Without Axial Loading. Spine, 9(6), 566-573. doi:10.1097/00007632-198409000-00006

Sengupta, D. K., Demetropoulos, C. K., & Herkowitz, H. N. (2003). Instant centre of rotation and intradiscal pressure study to identify load-sharing property of dynamic stabilization devices in the lumbar spine without fusion – a biomechanical study in cadaver spine, World Spine II. Chicago, Aug 2003.

Simpson, E. K., Parkinson, I. H., Manthey, B., & Fazzalari, N. L. (2001). Intervertebral Disc Disorganization Is Related to Trabecular Bone Architecture in the Lumbar Spine. Journal of Bone and Mineral Research, 16(4), 681-687. doi:10.1359/jbmr.2001.16.4.681

Stoll, T. M., Dubois, G., & Schwarzenbach, O. (2002). The dynamic neutralization system for the spine: A multicenter study of a novel non-fusion system. The European Spine Journal, 11(Suppl 2), 170–178.

Swanson, K. E., Lindsey, D. P., Hsu, K. Y., Zucherman, J. F., & Yerby, S. A. (2003). The Effects of an Interspinous Implant on Intervertebral Disc Pressures. Spine, 28(1), 26-32. doi:10.1097/00007632-200301010-00008

Weinhoffer, S. L., Guyer, R. D., Herbert, M., & Griffith, S. L. (1995). Intradiscal Pressure Measurements Above an Instrumented Fusion. Spine, 20(5), 526-531. doi:10.1097/00007632-199503010-00004




Copyright (c) 2018 Bambang Darwono, Volodymyr Radchenko

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.