{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:33:45Z","timestamp":1790228025459,"version":"4.1.0"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>The degenerative process of the spinal column results in instability followed by a progressive loss of segmental motion. Segmental degeneration is associated with intervertebral disc and facet changes, which can be quantified. Correlating this degeneration with clinical segmental motion has not been investigated in the thoracic spine. The authors sought to determine if imaging-determined degeneration would correlate with native range of motion (ROM) or the change in ROM after decompressive procedures, potentially guiding clinical decision making in the setting of spine trauma or following decompressive procedures in the thoracic spine.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Multidirectional flexibility tests with image analysis were performed on thoracic cadaveric spines with intact ib cage. Specimens consisted of 19 fresh frozen human cadaveric spines, spanning C-7 to L-1. ROM was obtained for each specimen in axial rotation (AR), flexion-extension (FE), and lateral bending (LB) in the intact state and following laminectomy, unilateral facetectomy, and unilateral costotransversectomy performed at either T4\u20135 (in 9 specimens) or T8\u20139 (in 10 specimens). Image grading of segmental degeneration was performed utilizing 3D CT reconstructions. Imaging scores were obtained for disc space degeneration, which quantified osteophytes, narrowing, and endplate sclerosis, all contributing to the Lane disc summary score. Facet degeneration was quantified using the Weishaupt facet summary score, which included the scoring of facet osteophytes, narrowing, hypertrophy, subchondral erosions, and cysts.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The native ROM of specimens from T-1 to T-12 (n = 19) negatively correlated with age in AR (Pearson\u2019s r coefficient = -0.42, p = 0.070) and FE (r = -0.42, p = 0.076). When regional ROM (across 4 adjacent segments) was considered, the presence of disc osteophytes negatively correlated with FE (r = \u22120.69, p = 0.012), LB (r = \u22120.82, p = 0.001), and disc narrowing trended toward significance in AR (r = \u22120.49, p = 0.107). Facet characteristics, scored using multiple variables, showed minimal correlation to native ROM (r range from \u22120.45 to +0.19); however, facet degeneration scores at the surgical level revealed strong negative correlations with regional thoracic stability following decompressive procedures in AR and LB (Weishaupt facet summary score: r = \u22120.52 and r = \u22120.71; p = 0.084 and p = 0.010, respectively). Disc degeneration was not correlated (Lane disc summary score: r = \u22120.06, p = 0.861).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Advanced age was the most important determinant of decreasing native thoracic ROM, whereas imaging characteristics (T1\u201312) did not correlate with the native ROM of thoracic specimens with intact rib cages. Advanced facet degeneration at the surgical level did correlate to specimen stability following decompressive procedures, and is likely indicative of the terminal stages of segmental degeneration.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.12.spine131112","type":"journal-article","created":{"date-parts":[[2015,5,15]],"date-time":"2015-05-15T14:35:22Z","timestamp":1431700522000},"page":"170-177","source":"Crossref","is-referenced-by-count":19,"title":["Thoracic range of motion, stability, and correlation to imaging-determined degeneration"],"prefix":"10.3171","volume":"23","author":[{"given":"Andrew T.","family":"Healy","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery and"},{"name":"Head and Neck Research Lab, Cleveland Clinic;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasath","family":"Mageswaran","sequence":"additional","affiliation":[{"name":"Head and Neck Research Lab, Cleveland Clinic;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Lubelski","sequence":"additional","affiliation":[{"name":"Case Western Reserve University Lerner College of Medicine, Cleveland, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin P.","family":"Rosenbaum","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virgilio","family":"Matheus","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Southeastern Regional Medical Center, Lumberton, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward C.","family":"Benzel","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and"},{"name":"Head and Neck Research Lab, Cleveland Clinic;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E.","family":"Mroz","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and"},{"name":"Head and Neck Research Lab, Cleveland Clinic;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine131112","series-title":"J Bone Joint Surg Br","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1302\/0301-620X.39B2.339","article-title":"Movements of the lumbar spinal column","volume":"39-B","author":"Allbrook","year":"1957"},{"key":"b2-spine131112","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"2640","DOI":"10.1007\/s00586-012-2250-y","article-title":"Which factors prognosticate spinal instability following lumbar laminectomy?","volume":"21","author":"Bisschop","year":"2012"},{"key":"b3-spine131112","series-title":"J Belge Radiol","first-page":"81","article-title":"Osteoarthritis of the facet joints and its role in low-back pain: evaluation with conventional tomography","volume":"75","author":"Demaerel","year":"1992"},{"key":"b4-spine131112","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1007\/s005860050193","article-title":"The relationship between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI study","volume":"8","author":"Fujiwara","year":"1999"},{"key":"b5-spine131112","series-title":"AJNR Am J Neuroradiol","first-page":"1325","article-title":"Lumbar facet joint tropism does not accelerate degeneration of the facet joints","volume":"18","author":"Grogan","year":"1997"},{"key":"b6-spine131112","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1097\/00007632-199204000-00007","article-title":"A cadaveric study comparing discography, magnetic resonance imaging, histology, and mechanical behavior of the human lumbar disc","volume":"17","author":"Gunzburg","year":"1992"},{"key":"b7-spine131112","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.1016\/j.spinee.2013.11.035","article-title":"Biomechanical analysis of the upper thoracic spine after decompressive procedures","volume":"14","author":"Healy","year":"2014"},{"key":"b8-spine131112","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1007\/s00586-005-0954-y","article-title":"Review of existing grading systems for cervical or lumbar disc and facet joint degeneration","volume":"15","author":"Kettler","year":"2006"},{"key":"b9-spine131112","series-title":"Clin Orthop Relat Res","first-page":"110","article-title":"Instability of the lumbar spine","volume":"165","author":"Kirkaldy-Willis","year":"1982"},{"key":"b10-spine131112","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2537","DOI":"10.1097\/BRS.0b013e3181b353ea","article-title":"Lumbar segmental mobility according to the grade of the disc, the facet joint, the muscle, and the ligament pathology by using kinetic magnetic resonance imaging","volume":"34","author":"Kong","year":"2009"},{"key":"b11-spine131112","series-title":"J Rheumatol","first-page":"1911","article-title":"Reliability of new indices of radiographic osteoarthritis of the hand and hip and lumbar disc degeneration","volume":"20","author":"Lane","year":"1993"},{"key":"b12-spine131112","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1097\/BRS.0b013e3181c9b8d6","article-title":"The effect of bilateral laminotomy versus laminectomy on the motion and stiffness of the human lumbar spine: a biomechanical comparison","volume":"35","author":"Lee","year":"2010"},{"key":"b13-spine131112","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E629","DOI":"10.1097\/BRS.0b013e3181faaef7","article-title":"Lumbar facet joint motion in patients with degenerative disc disease at affected and adjacent levels: an in vivo biomechanical study","volume":"36","author":"Li","year":"2011"},{"key":"b14-spine131112","series-title":"Acta Orthop Scand","doi-asserted-by":"publisher","first-page":"241","DOI":"10.3109\/17453676608989412","article-title":"Determination of the sagittal mobility of the lumbar spine. 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