{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,20]],"date-time":"2025-07-20T04:02:59Z","timestamp":1752984179640,"version":"3.37.3"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T00:00:00Z","timestamp":1656460800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T00:00:00Z","timestamp":1656460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006447","name":"University of Zurich","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006447","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>While anteroposterior instability of spinal segments is regarded as an important biomechanical aspect in the clinical evaluation of lumbar pathologies, the reliability of the available diagnostic tools is limited and an intraoperative method to quantify stability is lacking. The aim of this study was to develop and validate an instrument to measure the anteroposterior stability of a spinal segments in real-time.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Torsi of five fresh-frozen human cadavers were used for this study. After pedicle screw insertion, a specifically modified reposition tool composed with load and linear sensors was used to measure the segmental anteroposterior motion caused by 100\u00a0N anterior and posterior force during 5 loading cycles on either side of the instrumentation by two different operators. The spinal segments were then resected from the torsi and anteroposterior loading with\u2009\u00b1\u2009100\u00a0N was repeated in an advanced biomechanical spine testing setup as a reference measurement. The Inter-correlation coefficient (ICC) was used for validation of the \u201cintraoperative\u201d device.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Inter-operator repeatability of the measurements showed an ICC of 0.93 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and the bilateral (left\u2013right) comparison had an ICC of 0.73 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). The ICC resulting from the comparison to the reference measurement was 0.82 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) without offset correction, and 0.9 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) with offset correction. The ICC converged at this value already after two of the five performed loading cycles.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>An accurate and reliable measurement tool is developed and validated for real-time quantification of anteroposterior stability of spinal segments and serves as a basis for future intraoperative use.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00586-022-07286-9","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T12:03:24Z","timestamp":1656504204000},"page":"2368-2376","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Real-time assessment of anteroposterior stability of spinal segments"],"prefix":"10.1007","volume":"31","author":[{"given":"Fr\u00e9d\u00e9ric","family":"Cornaz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Haupt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mazda","family":"Farshad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3676-008X","authenticated-orcid":false,"given":"Jonas","family":"Widmer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,6,29]]},"reference":[{"key":"7286_CR1","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1148\/radiol.2451051359","volume":"245","author":"A Leone","year":"2007","unstructured":"Leone A, Guglielmi G, Cassar-Pullicino VN, Bonomo L (2007) Lumbar intervertebral instability: a review. Radiology 245:62\u201377. https:\/\/doi.org\/10.1148\/radiol.2451051359","journal-title":"Radiology"},{"key":"7286_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4172\/2167-7964.1000178","volume":"04","author":"A Splendiani","year":"2015","unstructured":"Splendiani A (2015) Lumbar spinal instability: an updated review. Omi J Radiol 04:1\u20135. https:\/\/doi.org\/10.4172\/2167-7964.1000178","journal-title":"Omi J Radiol"},{"key":"7286_CR3","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1097\/00002517-200010000-00013","volume":"13","author":"A Fujiwara","year":"2000","unstructured":"Fujiwara A, Tamai K, An HS et al (2000) The relationship between disc degeneration, facet joint osteoarthritis, and stability of the degenerative lumbar spine. J Spinal Disord 13:444\u2013450. https:\/\/doi.org\/10.1097\/00002517-200010000-00013","journal-title":"J Spinal Disord"},{"key":"7286_CR4","doi-asserted-by":"publisher","first-page":"24","DOI":"10.3340\/jkns.2009.45.1.24","volume":"45","author":"SY Jang","year":"2009","unstructured":"Jang SY, Kong MH, Hymanson HJ et al (2009) Radiographic parameters of segmental instability in lumbar spine using kinetic MRI. J Korean Neurosurg Soc 45:24\u201331. https:\/\/doi.org\/10.3340\/jkns.2009.45.1.24","journal-title":"J Korean Neurosurg Soc"},{"key":"7286_CR5","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1097\/01.bsd.0000102473.95064.9d","volume":"17","author":"T Iguchi","year":"2004","unstructured":"Iguchi T, Kanemura A, Kasahara K et al (2004) Lumbar instability and clinical symptoms: which is the more critical factor for symptoms: sagittal translation or segment angulation? J Spinal Disord Tech 17:284\u2013290. https:\/\/doi.org\/10.1097\/01.bsd.0000102473.95064.9d","journal-title":"J Spinal Disord Tech"},{"key":"7286_CR6","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1148\/radiology.166.1.3336678","volume":"166","author":"MT Modic","year":"1988","unstructured":"Modic MT, Steinberg PM, Ross JS et al (1988) Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 166:193\u2013199. https:\/\/doi.org\/10.1148\/radiology.166.1.3336678","journal-title":"Radiology"},{"key":"7286_CR7","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1097\/00002517-199902000-00006","volume":"12","author":"K Yone","year":"1999","unstructured":"Yone K, Sakou T (1999) Usefulness of Posner\u2019s definition of spinal instability for selection of surgical treatment for lumbar spinal stenosis. J Spinal Disord 12:40\u201344","journal-title":"J Spinal Disord"},{"key":"7286_CR8","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-8389(05)70263-3","author":"RS Nizard","year":"2001","unstructured":"Nizard RS, Wybier M, Laredo JD (2001) Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis. Radiol Clin North Am. https:\/\/doi.org\/10.1016\/S0033-8389(05)70263-3","journal-title":"Radiol Clin North Am"},{"key":"7286_CR9","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1097\/00007632-199701150-00012","volume":"22","author":"M Pitk\u00e4nen","year":"1997","unstructured":"Pitk\u00e4nen M, Manninen HI, Lindgren K-A et al (1997) Limited usefulness of traction-compression films in the radiographic diagnosis of lumbar spinal instability. Spine (Phila Pa 1976) 22:193\u2013197. https:\/\/doi.org\/10.1097\/00007632-199701150-00012","journal-title":"Spine (Phila Pa 1976)"},{"key":"7286_CR10","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1097\/00007632-198703000-00007","volume":"12","author":"O Friberg","year":"1987","unstructured":"Friberg O (1987) Lumbar instability: a dynamic approach by traction-compression radiography. Spine (Phila Pa 1976) 12:119\u2013129. https:\/\/doi.org\/10.1097\/00007632-198703000-00007","journal-title":"Spine (Phila Pa 1976)"},{"key":"7286_CR11","doi-asserted-by":"publisher","first-page":"e717","DOI":"10.1016\/j.wneu.2018.07.253","volume":"119","author":"HM Li","year":"2018","unstructured":"Li HM, Zhang RJ, Gao H et al (2018) Biomechanical fixation properties of the cortical bone trajectory in the osteoporotic lumbar spine. World Neurosurg 119:e717\u2013e727. https:\/\/doi.org\/10.1016\/j.wneu.2018.07.253","journal-title":"World Neurosurg"},{"key":"7286_CR12","doi-asserted-by":"publisher","first-page":"110577","DOI":"10.1016\/j.jbiomech.2021.110577","volume":"125","author":"F Cornaz","year":"2021","unstructured":"Cornaz F, Burkhard M, Fasser MR et al (2021) 3D printed clamps for fixation of spinal segments in biomechanical testing. J Biomech 125:110577. https:\/\/doi.org\/10.1016\/j.jbiomech.2021.110577","journal-title":"J Biomech"},{"key":"7286_CR13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2019.109467","volume":"98","author":"F Cornaz","year":"2020","unstructured":"Cornaz F, Fasser M-R, Spirig JM et al (2020) 3D printed clamps improve spine specimen fixation in biomechanical testing. J Biomech 98:109467. https:\/\/doi.org\/10.1016\/j.jbiomech.2019.109467","journal-title":"J Biomech"},{"key":"7286_CR14","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.1016\/j.spinee.2020.05.541","volume":"20","author":"J Widmer","year":"2020","unstructured":"Widmer J, Cornaz F, Scheibler G et al (2020) Biomechanical contribution of spinal structures to stability of the lumbar spine\u2014novel biomechanical insights. Spine J 20:1705\u20131716. https:\/\/doi.org\/10.1016\/j.spinee.2020.05.541","journal-title":"Spine J"},{"key":"7286_CR15","doi-asserted-by":"publisher","first-page":"E869","DOI":"10.1097\/brs.0000000000003883","volume":"6","author":"F Cornaz","year":"2021","unstructured":"Cornaz F, Widmer J, Farshad-Amacker NA et al (2021) Biomechanical contributions of spinal structures with different degrees of disc degeneration. Spine (Phila Pa 1976) 6:E869\u2013E877. https:\/\/doi.org\/10.1097\/brs.0000000000003883","journal-title":"Spine (Phila Pa 1976)"},{"key":"7286_CR16","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1037\/0033-2909.86.2.420","volume":"86","author":"PE Shrout","year":"1979","unstructured":"Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420\u2013428. https:\/\/doi.org\/10.1037\/0033-2909.86.2.420","journal-title":"Psychol Bull"},{"key":"7286_CR17","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","volume":"15","author":"TK Koo","year":"2016","unstructured":"Koo TK, Li MY (2016) A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 15:155\u2013163. https:\/\/doi.org\/10.1016\/j.jcm.2016.02.012","journal-title":"J Chiropr Med"}],"container-title":["European Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-022-07286-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00586-022-07286-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-022-07286-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T13:20:22Z","timestamp":1662124822000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00586-022-07286-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,29]]},"references-count":17,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["7286"],"URL":"https:\/\/doi.org\/10.1007\/s00586-022-07286-9","relation":{},"ISSN":["0940-6719","1432-0932"],"issn-type":[{"type":"print","value":"0940-6719"},{"type":"electronic","value":"1432-0932"}],"subject":[],"published":{"date-parts":[[2022,6,29]]},"assertion":[{"value":"13 October 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 April 2022","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 June 2022","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2022","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None in relation to the content of this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval for the cadaveric experiments was obtained by the local authorities (BASEC Nr.: 2021-00207, Kantonale Ethikkomission, Kanton Z\u00fcrich, Switzerland).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}