Semin Musculoskelet Radiol 2005; 09(1): 88-99
DOI: 10.1055/s-2005-867101
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001 USA.

Imaging of Spine Instability

Mini Pathria1
  • 1Department of Radiology, University of California, San Diego School of Medicine, San Diego, California
Further Information

Publication History

Publication Date:
05 April 2005 (online)

ABSTRACT

Spine instability is an important cause of back pain and disability. The most common causes of clinical instability are spinal trauma, congenital anomalies, inflammatory disorders, degenerative disease, and prior surgery. Imaging of spine instability relies on both static anatomic imaging and functional assessment of spine motion. This chapter reviews the complexity of defining instability and reviews the common antecedents of spine instability and their imaging features.

REFERENCES

  • 1 White A A, Johnson R M, Panjabi M M et al.. Biomechanical analysis of clinical stability in the cervical spine.  Clin Orthop. 1975;  109 85-96
  • 2 White A A, Southwick W O, Panjabi M M. Clinical instability in the lower cervical spine: a review of past and current concepts.  Spine. 1976;  1 15-27
  • 3 White A A, Panjabi M M. Clinical Biomechanics of the Spine, 2nd ed. Philadelphia; Lippincott Williams & Wilkins 1990
  • 4 Bedbrook G M. Stability of spinal fractures and fracture dislocations.  Paraplegia. 1971;  9 23-32
  • 5 Benedetti P F, Fahr L M, Kuhns L R, Hayman L A. MR imaging findings in spinal ligamentous injury.  AJR Am J Roentgenol. 2000;  175 661-665
  • 6 Nicoll E A. Fractures of the dorso-lumbar spine.  J Bone Joint Surg Br. 1949;  31 376-394
  • 7 Holdsworth F W. Fractures, dislocations, and fracture-dislocations of the spine.  J Bone Joint Surg Br. 1963;  45 6-20
  • 8 Roaf R. A study of the mechanics of spinal injuries.  J Bone Joint Surg Br. 1960;  42 810
  • 9 Whitesides T E. Traumatic kyphosis of the thoracolumbar spine.  Clin Orthop. 1977;  128 78-92
  • 10 Ferguson R L, Allen Jr B L. A mechanistic classification of thoracolumbar spine fractures.  Clin Orthop. 1984;  189 77-88
  • 11 Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries.  Spine. 1983;  8 817-831
  • 12 Denis F. Spinal instability as defined by the three-column spine concept in acute spinal trauma.  Clin Orthop. 1984;  189 65-76
  • 13 Daffner R H, Deeb Z L, Goldberg A L, Kandabarow A, Rothfus W E. The radiologic assessment of post-traumatic vertebral stability.  Skeletal Radiol. 1990;  19 103-108
  • 14 Green J D, Harle T S, Harris J H. Anterior subluxation of the cervical spine: Hyperflexion sprain.  AJNR Am J Neuroradiol. 1981;  2 243-250
  • 15 Petersilge C A, Pathria M N, Emery S E, Masaryk T J. Thoracolumbar burst fractures: evaluation with MR imaging.  Radiology. 1995;  194 49-54
  • 16 Terk M R, Hume-Neal M, Fraipont M, Ahmadi J, Colletti P M. Injury of the posterior ligament complex in patients with acute spinal trauma: Evaluation by MR imaging.  AJR Am J Roentgenol. 1997;  168 1481-1486
  • 17 Brower A C, Allman R M. Pathogenesis of the neuropathic joint: Neurotraumatic vs. neurovascular.  Radiology. 1981;  139 349-354
  • 18 Park Y H, Taylor J AM, Szollar S M, Resnick D. Imaging findings in spinal neuroarthropathy.  Spine. 1994;  19 1499-1504
  • 19 Wagner S C, Schweitzer M E, Morrison W B, Przybylski G J, Parker L. Can imaging findings help differentiate spinal neuropathic arthropathy from disk space infection? Initial experience.  Radiology. 2000;  214 693-699
  • 20 Morrell D S, Pearson M J, Sauser D D. Progressive bone and joint abnormalities of the spine and lower extremities in cerebral palsy.  Radiographics. 2002;  22 257-268
  • 21 Fuji T, Yonenobu K, Fujiwara K et al.. Cervical radiculopathy or myelopathy secondary to athetoid cerebral palsy.  J Bone Joint Surg Am. 1987;  69 815-821
  • 22 Greenberg A D. Atlanto-axial dislocations.  Brain. 1968;  91 655-584
  • 23 Taybi H, Lachman R S. Radiology of Syndromes, Metabolic Disorders, and Skeletal Dysplasias, 4th ed St. Louis, MO; Mosby-Year Book 1996
  • 24 White K S, Ball W S, Prenger E C et al.. Evaluation of the craniocervical junction in Down syndrome: Correlation of measurements obtained with radiography and MR imaging.  Radiology. 1993;  186 377-382
  • 25 Weissman B N, Aliabadi P, Weinfeld M S, Thomas W H, Sosman J L. Prognostic features of atlantoaxial subluxation in rheumatoid arthritis patients.  Radiology. 1982;  144 745-751
  • 26 Oostveen J C, van de Laar M A. Magnetic resonance imaging in rheumatic disorders of the spine and sacroiliac joints.  Semin Arthritis Rheum. 2000;  30 52-69
  • 27 Reynolds H, Carter S W, Murtagh F R, Rechtine G R. Cervical rheumatoid arthritis: value of flexion and extension views in imaging.  Radiology. 1987;  164 215-218
  • 28 Smith A S, Blaser S I. Infectious and inflammatory processes of the spine.  Radiol Clin North Am. 1991;  29 809-827
  • 29 Rinaldi I, Mullins W J, Delaney W F, Fitzer P M, Tornberg D N. Computerized tomographic demonstration of rotational atlanto-axial fixation: Case report.  J Neurosurg. 1979;  50 115-119
  • 30 Wetzel F T, La Rocca H. Grisel's syndrome.  Clin Orthop. 1989;  240 141-152
  • 31 Resnick D. Degenerative diseases of the vertebral column.  Radiology. 1985;  156 3-14
  • 32 Spivak J M. Degenerative lumbar spinal stenosis.  J Bone Joint Surg Am. 1998;  80 1053-1066
  • 33 Katz J N, Lipson S J, Larson M G, McInnes J M, Fossel A H, Liang M H. The outcome of decompressive laminectomy for degenerative lumbar stenosis.  J Bone Joint Surg Am. 1991;  73 809-816
  • 34 Nakai O, Ookawa A, Yamaura I. Long-term roentgenographic and functional changes in patients who were treated with wide fenestration for central lumbar stenosis.  J Bone Joint Surg Am. 1991;  73 1184-1191
  • 35 Johnsson K, Willner S, Johnsson K. Postoperative instability after decompression for lumbar spinal stenosis.  Spine. 1986;  11 107-110
  • 36 Garfin S R, Herkowitz H N, Mirkovic S. Spinal stenosis.  J Bone Joint Surg Am. 1999;  81 572
  • 37 Lonstein J E. Post-laminectomy kyphosis.  Clin Orthop. 1977;  128 93-100
  • 38 Wiesel S W. Neurologic complications and lumbar laminectomy: a standardized approach to the multiply operated lumbar spine. In: Garfin SR Complications of Spine Surgery. Baltimore; Williams & Wilkins 1989: 64
  • 39 Sim F H, Svien H J, Bickel W H, Janes J M. Swan-neck deformity following extensive cervical laminectomy.  J Bone Joint Surg Am. 1974;  56 564-580
  • 40 Aronson D D, Kahn R H, Canady A et al.. Instability of the cervical spine after decompression in patients who have Arnold-Chiari malformation.  J Bone Joint Surg Am. 1991;  73 898-906
  • 41 Steinmann J C, Herkowitz H N. Pseudarthrosis of the spine.  Clin Orthop. 1992;  284 80-90
  • 42 Chafetz N, Cann C E, Morris J M et al.. Pseudarthrosis following lumbar fusion: Detection by direct coronal CT scanning.  Radiology. 1987;  162 803-805
  • 43 Cleveland M, Bosworth D M, Thompson F R. Pseudarthrosis in the lumbosacral spine.  J Bone Joint Surg Am. 1948;  30 302

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