Association between facet joint orientation/tropism and lumbar intervertebral disc degeneration

Ekşi, Murat Şakir; Özcan-Ekşi, Emel Ece; Orhun, Ömer; Huet, Sibel Emilie; Turgut, Veli Umut; Pamir, M. Necmettin

doi:10.1080/02688697.2020.1864289

Cited by 13 publications

(10 citation statements)

References 28 publications

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“… 27 , 28 Thus, more remarkable FJ tropism may accelerate disc degeneration and lead to lumbar stenosis. 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

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Quantitative Radiological Characteristics of the Facet Joints in Patients with Lumbar Foraminal Stenosis

Wang¹,

Wang²,

Zang³

et al. 2022

JPR

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Purpose This study aimed to evaluate the degeneration patterns of the facet joints (FJs) in patients with lumbar foraminal stenosis (LFS) and investigate the correlation between quantitative parameters and FJ osteoarthritis (FJ OA). Patients and Methods A total of 171 patients with LFS at the L4/5 level and 146 control patients were enrolled in this study. The severity of FJ OA was graded according to the Weishaupt classification. The FJ orientation, FJ tropism, superior articular process cross-sectional area (SAPA), and FJ area were measured at the L3/4, L4/5, and L5/S1 spinal levels. Associations among the parameters were assessed using Pearson’s correlation coefficients. Independent sample t -tests and Pearson’s chi-square tests were used for univariate analyses. The association between LFS and the quantitative parameters was also analyzed using multivariate logistic regression models adjusted for age, gender, and body mass index. Results Patients with LFS had more sagittal FJ orientation (37.9 vs 45.0, p < 0.001), more FJ tropism (5.6 vs 3.8, p < 0.001), larger SAPA (129.0 vs 97.8, p < 0.001), and less FJ area (21.7 vs 23.3, p = 0.016). Logistic regression analysis showed that LFS was significantly associated with FJ tropism (odds ratio [OR]: 1.153; p = 0.003) and SAPA (OR: 1.113; p < 0.001). The SAPA showed the largest area under the curve (0.908, 95% confidence interval: 0.875–0.942) for the diagnosis of LFS. The optimal cutoff value was 114.75 mm2 with 85.4% sensitivity and 87.0% specificity. Additionally, a significant correlation was observed between FJ OA and SAPA and FJ area at each studied spinal level. Conclusion This study confirmed that LFS is significantly associated with FJ hypertrophy and tropism. FJ hypertrophy and joint space narrowing correlated with the severity of FJ OA. These results are helpful in understanding the morphology and pathology of FJs.

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“… 27 , 28 Thus, more remarkable FJ tropism may accelerate disc degeneration and lead to lumbar stenosis. 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

“…27,28 Thus, more remarkable FJ tropism may accelerate disc degeneration and lead to lumbar stenosis. 29,30 In recent years, the SAPA has received increasing attention. Although Barry 22 concluded that FJ hypertrophy was a misnomer, many subsequent studies considered the SAPA as an important parameter.…”

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confidence: 99%

Quantitative Radiological Characteristics of the Facet Joints in Patients with Lumbar Foraminal Stenosis

Wang¹,

Wang²,

Zang³

et al. 2022

JPR

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“…Facet joint orientation and facet joint tropism are closely linked to disc degeneration in the lumbar spine. [ 5 ] Modic alterations and lipid infiltration in the multifidus and erector spinae muscles are also linked to disc degeneration. [ 6 ] The first step in the treatment is conservative in mild cases, but its benefit is limited because the symptoms are aggravated by movement.…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical and radiological results of dynamic and rigid instrumentation in degenerative lumbar spinal stenosis

Yaltirik

Varol

Etli

et al. 2022

Journal of Craniovertebral Junction and Spine

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Objective Lumbar spinal stenosis is defined as a clinical syndrome characterized by neurogenic claudication or radicular pain due to the narrowing of the spinal canal or neural foramen and the compression of its neural elements. Surgical treatment is applied to decompress the neural structures. In some cases, transpedicular instrumentation and fusion may also be applied. In this study, we aimed to investigate and compare the preoperative and postoperative, clinical and radiological aspects of patients with lumbar spinal stenosis who underwent lumbar instrumentation using a polyetheretherketone (PEEK) rod or a titanium rod. Materials and Methods: In this study, the files of 293 patients who underwent posterior lumbar transpedicular stabilization between January 2015 and February 2018 in the Neurosurgery Clinic of Ümraniye Training and Research Hospital were reviewed retrospectively. Patients who did not meet the study criteria were excluded, and 127 patients who met the criteria and underwent posterior lumbar transpedicular stabilization due to lumbar spinal stenosis and/or lumbar degenerative disc disease were retrospectively reviewed. The patients were divided into two groups, dynamic and rigid, according to the rod types used. The two groups were compared using various postoperative clinical and radiological parameters. Results: The demographic data, surgical data, Visual Analog Scale-Oswestry Disability Index (VAS-ODI) data, and radiological data of both groups were carefully examined. There were 63 patients in the rigid group and 64 patients in the dynamic group. The age range in both groups was from 30 to 78 years, with a mean age of 56.44 years; 99 of the cases were female and 28 were male. The analysis of the participants' demographic data showed no significant differences between the two groups. Compared with the preoperative data, the postoperative evaluations revealed a significant decrease in VAS and ODI, but no significant difference was observed between the two groups. There was no difference between the two groups in terms of duration of surgery, follow-up time, operating distances, hospitalization duration, pseudoarthrosis, or fusion. Regarding the total and segmental range of motion, the affection was less in the dynamic group, which allowed for more movement. While there was no difference in disc height index between the two preoperative groups, it was observed that it was better maintained in the rigid group in the postoperative long term. Regarding foraminal height (FH), there was no difference between the two groups in the preoperative and early postoperative periods, but in the long term, FH was better maintained in the dynamic group. The long-term follow-ups revealed that adjacent segment disease (ASD) had developed in 19 patients in the rigid group, whereas ASD developed in only nine patients in the dynamic group. Based on these results, the probability of developing significant ASD in the rigid group was higher. ...

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“…FJT increased at lower lumbar levels. 28 The axial and sagittal orientation of facet joints in the lower lumbar vertebra, especially L4/5, was negatively correlated with age. 29 There have been many studies that demonstrated a close association between FJO and FJT with lumbar degeneration.…”

Section: Pathogenesismentioning

confidence: 94%

Facet Joint Syndrome: Pathophysiology, Diagnosis, and Treatment

Du¹,

Xu²,

Bai³

2022

JPR

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Facet joint osteoarthritis (OA) is the most frequent form of facet joint syndrome. Medical history, referred pain patterns, physical examination, and diagnostic imaging studies (standard radiographs, magnetic resonance imaging, computed tomography and single-photon emission computed tomography) may suggest but not confirm lumbar facet joint (LFJ) syndrome as a source of low back pain (LBP). However, the diagnosis and treatment of facet joint syndrome is still controversial and needs further study. It is widely acknowledged that block with local anesthetic is perhaps the most effective method to establish a diagnosis of pain from LFJ. Particularly, there are different rates of success among different populations selected for diagnostic block with various positive criteria. Currently, in addition to conservative treatments for pain such as painkillers, functional exercises, and massage, there are many other methods, including block, denervation of the nerves that innervate the joints by radiofrequency, freezing or endoscopy, and injections. Due to the limited duration of pain relief from neurolysis of medial branch, many scholars have recently turned their targets to dorsal roots and LFJ capsules. Therefore, we reviewed the latest research progress of facet joint syndrome from diagnosis to treatment.

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Association between facet joint orientation/tropism and lumbar intervertebral disc degeneration

Cited by 13 publications

References 28 publications

Quantitative Radiological Characteristics of the Facet Joints in Patients with Lumbar Foraminal Stenosis

Quantitative Radiological Characteristics of the Facet Joints in Patients with Lumbar Foraminal Stenosis

Comparison of clinical and radiological results of dynamic and rigid instrumentation in degenerative lumbar spinal stenosis

Facet Joint Syndrome: Pathophysiology, Diagnosis, and Treatment

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