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Abstract Background Spine disorders are becoming more prevalent in today’s ageing society. Motion abnormalities have been linked to the prevalence and recurrence of these disorders. Various protocols exist to measure thoracolumbar spine motion, but a standard multi-segmental approach is still missing. This study aims to systematically evaluate the literature on stereophotogrammetric motion analysis approaches to quantify thoracolumbar spine kinematics in terms of measurement reliability, suitability of protocols for clinical application and clinical significance of the resulting functional assessment. Methods Electronic databases (PubMed, Scopus and ScienceDirect) were searched until February 2022. Studies published in English, investigating the intersegmental kinematics of the thoracolumbar spine using stereophotogrammetric motion analysis were identified. All information relating to measurement reliability; measurement suitability and clinical significance was extracted from the studies identified. Results Seventy-four studies met the inclusion criteria. 33% of the studies reported on the repeatability of their measurement. In terms of suitability, only 35% of protocols were deemed suitable for clinical application. The spinous processes of C7, T3, T6, T12, L1, L3 and L5 were the most widely used landmarks. The spine segment definitions were, however, found to be inconsistent among studies. Activities of daily living were the main tasks performed. Comparable results between protocols are however still missing. Conclusion The literature to date offers various stereophotogrammetric protocols to quantify the multi-segmental motion of the thoracolumbar spine, without a standard guideline being followed. From a clinical point of view, the approaches are still limited. Further research is needed to define a precise motion analysis protocol in terms of segment definition and clinical relevance.

Abstract Background Lumbar spinal stenosis, often accompanied by degenerative spondylolisthesis, is one of the most common conditions in the elderly. Decompression and fusion is a well-accepted treatment for single-segment lumbar spinal stenosis with degenerative spondylolisthesis; however, the treatment for multi-segment lumbar spinal stenosis with single-segment degenerative spondylolisthesis (MLSS) remains controversial. The objective of this study is to compare the effectiveness of selective decompression and fusion to multi-segmental decompression and fusion for MLSS. Methods A total of 42 patients suffering from MLSS who underwent surgery between June 2012 and January 2015 were included in this analysis. Of the 42 patients with minimum 3-year follow-up, 22 underwent selective decompression and fusion, and 20 patients underwent multi-segmental decompression and fusion. Age, gender, symptom duration, operative time, blood loss, the number of decompressed segment and fused segment, and complication were compared between the two groups. The visual analog scale (VAS), Oswestry Disability Index (ODI) and Short Form 36 (SF-36) were used to assess efficacy. Results Operative time, blood loss, and the number of fused segment in multi-segmental decompression and fusion group were greater than those in selective decompression and fusion group (P 0.05). There was no iatrogenic spinal instability in the decompressed segments in selective decompression and fusion group, while three patients developed postoperative instability at the adjacent segments above the fused segments in multi-segmental decompression and fusion group at 3-year follow-up. Conclusions Selective decompression and fusion is a safe and effective method for the treatment of MLSS, with the advantages of shorter operative time, less blood loss, and more preservation of spinal motion segments when compared with multi-segmental decompression and fusion.