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2018, Number 2

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Revista Cubana de Ortopedia y Traumatología 2018; 32 (2)

Relations between disc degeneration and lumbar instability

Tabares NH, Díaz QJM, Tabares SH, Tabares SL

Language: Spanish
References: 47
Page: 1-16
PDF size: 331.78 Kb.


ABSTRACT

Introduction: Lumbar instability is one of the most frequent causes of back pain. Difficulties in diagnosis result its incidence to be lower than expected in clinical practice and make it difficult to treat.
Objective: To characterize and evaluate what is published regarding the process of disc degeneration, as well as its influence on the stability of the lumbar spine.
Methods: We reviewed the main advances related to disc degeneration that cause vertebral instability. Articles published in PubMed, in English, from 2012 to 2017 were consulted. Articles in open access or through Clinical Key and Hinari were studied. Some articles older than 5 years were taken into account, because they are relevant to the subject.
Results: Two processes affect the lumbar intervertebral disc because of aging and degeneration: deforming spondylosis and intervertebral osteochondrosis. The degenerative changes occur related to time and three phases can be differentiated that cascade triggers movement disorders and instability.
Conclusions: Vertebral degenerative changes produce increased segmental mobility, a possible cause of lumbar instability. The neutral zone is a parameter only measurable "in vitro". There is no evidence to confirm the diagnosis of vertebral instability. Clinical and imaging findings are the best recommendation to reach to a diagnosis. The concept of lumbar vertebral instability and its treatment through vertebral fusion are not sufficiently justified.


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