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Abstracts and Articles Discuss Effect of untreated degenerated disc on adjacent discs in the Main forums forums; Single-Level Degenerative Disc - Adjacent Segments FEA: J.Biomechanics 2009 Jan Epub -------------------------------------------------------------------------------- Journal of Biomechanics Article in Press Copyright © 2008 ...

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Old 01-17-2009, 01:43 PM
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Default Effect of untreated degenerated disc on adjacent discs

Single-Level Degenerative Disc - Adjacent Segments FEA: J.Biomechanics 2009 Jan Epub

--------------------------------------------------------------------------------

Journal of Biomechanics
Article in Press
Copyright © 2008 Elsevier Ltd All rights reserved.

Influence of single-level lumbar degenerative disc disease on the behavior of the adjacent segments—A finite element model study

Lissette M. Ruberté a, Raghu N. Natarajan a, b, and Gunnar BJ. Andersson b

a Department of Bioengineering, University of Illinois at Chicago, USA
b Department of Orthopedic Surgery, Rush University Medical Center, USA

Accepted 23 November 2008. Available online 10 January 2009.

Abstract

The current study investigated mechanical predictors for the development of adjacent disc degeneration. A 3-D finite element model of a lumbar spine was modified to simulate two grades of degeneration at the L4–L5 disc. Degeneration was modeled by changes in geometry and material properties. All models were subjected to follower preloads of 800 N and moment loads in the three principal directions of motion using a hybrid protocol.

Degeneration caused changes in the loading and motion patterns of the segments above and below the degenerated disc.

At the level (L3–L4) above the degenerated disc, the motion increased due to moderate degeneration by 21% under lateral bending, 26% under axial rotation and 28% under flexion/extension. At the level (L5-S1) below the degenerated disc, motion increased only during lateral bending by 20% due to moderate degeneration. Both the L3–L4 and L5-S1 segment showed a monotonic increase in both the maximum von Mises stress and shear stress in the annulus as degeneration progressed for all loading directions, expect extension at L3–L4. The most significant increase in stress was observed at the L5-S1 level during axial rotation with nearly a ten-fold increase in the maximum shear stress and 103% increase in the maximum von Mises stress. The L5-S1 segment also showed a progressive increase in facet contact force for all loading directions with degeneration. Nucleus pressure did not increase significantly for any loading direction at either the caudal or cephalic adjacent segment.

Results suggest that single-level degeneration can increase the risk for injury at the adjacent levels.

Keywords: Disc degeneration; Finite element; Lumbar; Spine
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Old 01-18-2009, 03:15 AM
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Very Interesting. Gives me yet another reason to move toward having surgery sooner, rather than later.
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Numerous MRI's, PT, chiropractic, accupuncture, TENS therapy, massage therapy, facet injections, epidural injections, Nerve study, Discogram, confirms pain in L4/5, IDET, decompression, Bi-lateral neurotomy L3/4/5, denied by insurance twice, in Active L clinical trial, had surgery March 17, 2009 in Miami, FL- received Active L disc
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Old 01-22-2009, 07:54 PM
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Yes, very interesting. I've printed out the original article to read.

And thanks Kathy for bringing this article to my attention.
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Cathy

46 years old. 12-15 years of intermittent pain, 2 years with constant pain.

DDD, L4-5 and L5-S1, pain confirmed by discogram.
PT, ESI's, Facet injection and block, Acupuncture - all no help.

2-level (Prodisc-L) ADR surgery with Dr. Bertagnoli, May 26, 2009.

Currently taking Opana-ER (tapering off) and oxycodone
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Old 01-23-2009, 03:20 AM
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Interesting article.

I wrote about this about a year ago.

Auto-Adjacent Segment Degeneration

I saw this in a client's films last summer. His neck looked just like mine and I could see in his flexion/extension images that the adjacent levels were not moving. That is what motivated me to schedule the cervical surgery... that I subsequently canceled.

Tough choices. There is no questions that sooner is better than later.... if you are successful!

Mark
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Old 07-25-2009, 11:48 AM
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this is bad news if it also pertains to cervical disc..i guess im gonna need surgery
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C4-5: Mild disc height loss with central annular fissure. Small broad-based left paracentral disc protrusion. Moderate central canal stenosis-the disc protrusion abuts and mildly flattens the left ventral surface of the spinal canal.

C5-6: Disc desiccation with mild height loss.Diffuse discosteophyte bulge and uncovertebral joint hypertrophy, moderate central canal stenosis- Severe neuroforaminal stenosis bilaterally, right greater than left.
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