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BioMed Research International
Volume 2015, Article ID 260703, 9 pages
http://dx.doi.org/10.1155/2015/260703
Clinical Study

A New CT Method for Assessing 3D Movements in Lumbar Facet Joints and Vertebrae in Patients before and after TDR

1Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institutet at Karolinska University Hospital Solna, 171 76 Stockholm, Sweden
2Stockholm Spine Center, Löwenströmska Hospital, 198 84 Upplands Väsby, Sweden
3Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
4School of Information and Communication Technology, KTH Royal Institute of Technology, 164 40 Kista, Sweden
5School of Computing, College of Engineering, University of Utah, Salt Lake City, UT 84109, USA
6Capio S:t Göran Sjukhuset, S:t Göransplan 1, 112 81 Stockholm, Sweden

Received 1 June 2015; Revised 22 September 2015; Accepted 5 October 2015

Academic Editor: Jau-Ching Wu

Copyright © 2015 Per Svedmark et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This study describes a 3D-CT method for analyzing facet joint motion and vertebral rotation in the lumbar spine after TDR. Ten patients were examined before and then three years after surgery, each time with two CT scans: provoked flexion and provoked extension. After 3D registration, the facet joint 3D translation and segmental vertebral 3D rotation were analyzed at the operated level (L5-S1) and adjacent level (L4-L5). Pain was evaluated using VAS. The median (±SD) 3D movement in the operated level for the left facet joint was 3.2 mm (±1.9 mm) before and 3.5 mm (±1.7 mm) after surgery and for the right facet joint was 3.0 mm (±1.0 mm) before and 3.6 mm (±1.4 mm) after surgery. The median vertebral rotation in the sagittal plane at the operated level was 5.4° (±2.3°) before surgery and 6.8° (±1.7°) after surgery and in the adjacent level was 7.7° (±4.0°) before and 9.2° (±2.7°) after surgery. The median VAS was reduced from 6 (range 5–8) to 3 (range 2–8) in extension and from 4 (range 2–6) to 2 (range 1–3) in flexion.