Facet Joint Degeneration of the Cervical Spine

Park, Moon Soo; Lee, Yong Beom; Moon, Seong Hwan; Lee, Hwan Mo; Kim, Tae Hwan; Oh, Jong Byung; Riew, K. Daniel

doi:10.1097/brs.0000000000000326

Cited by 47 publications

(27 citation statements)

References 17 publications

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“…[ 3 , 4 ] A total of 40% to 60% cases of chronic neck pain have been reported to be related to facet joints. [ 3 – 5 ] Bykowski and Wong [ 4 ] have previously reported that having greater than or equal to 3 facet joints involved may be more dangerous to have facet joint originated axial pain.…”

Section: Introductionmentioning

confidence: 99%

Facet joint disturbance induced by miniscrews in plated cervical laminoplasty

Chen

Wang

et al. 2016

Medicine

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A retrospective cohort study. Plated cervical laminoplasty is an increasingly common technique. A unique facet joint disturbance induced by lateral mass miniscrews penetrating articular surface was noticed. Facet joints are important to maintain cervical spine stability and kinetic balance. Whether this facet joint disturbance could affect clinical and radiologic results is still unknown. The objective of this study is to investigate the clinical and radiologic outcomes of patients with facet joints disturbance induced by miniscrews in plated cervical laminoplasty.A total of 105 patients who underwent cervical laminoplasty with miniplate fixation between May 2010 and February 2014 were comprised. Postoperative CT images were used to identify whether facet joints destroyed by miniscrews. According to facet joints destroyed number, all the patients were divided into: group A (none facet joint destroyed), group B (1–2 facet joints destroyed), and group C (≥3 facet joints destroyed). Clinical data (JOA, VAS, and NDI scores), radiologic data (anteroposterior diameter and Palov ratio), and complications (axial symptoms and C5 palsy) were evaluated and compared among the groups.There were 38, 40, and 27 patients in group A, B, and C, respectively. The overall facet joints destroyed rate was 30.7%. All groups gained significant JOA and NDI scores improvement postoperatively. The preoperative JOA, VAS, NDI scores, and postoperative JOA scores did not differ significantly among the groups. The group C recorded significant higher postoperative VAS scores than group A (P = 0.002) and B (P = 0.014) and had significant higher postoperative NDI scores than group A (P = 0.002). The pre- and postoperative radiologic data were not significant different among the groups. The group C had a significant higher axial symptoms incidence than group A (12/27 vs 8/38, P = 0.041).Facet joints disturbance caused by miniscrews in plated cervical laminoplasty may not influence neurological recovery and spinal canal expansion, but may negatively affect postoperative axial symptoms.

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Section: Introductionmentioning

confidence: 99%

Facet joint disturbance induced by miniscrews in plated cervical laminoplasty

Chen

Wang

et al. 2016

Medicine

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“…Pathological studies on fresh frozen cervical spine specimens, as well as tomographic studies, have shown that the prevalence of cervical facet joint degeneration increases with age [12,16,17]. In the literature, the rate of facet joint degeneration for C2-C7 intervertebral levels have been reported 91.3% in Grade I, 2.9% in Grade II, 5.2% in Grade III, and 0.6% in Grade IV in normal subjects between 40-79 years old [12]. The prevalence of facet joint degeneration in our control group were consistent with values reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Facet joints were evaluated in four categories according to the grading system which was suggested by Park et al [12]: Grade I, normal; Grade II, degenerative changes including joint space narrowing, cyst formation, small osteophytes without joint hypertrophy; Grade III, joint hypertrophy secondary to large osteophytes without fusion; Grade IV, bony fusion of the joint. Then, the facet joints in each intervertebral level was scored with the following scoring system: grade I: 1 point, grade II: 2 points, grade III: 3 points, grade IV: 4 points.…”

Section: Methodsmentioning

confidence: 99%

Computed Tomographic Evaluation of Degenerative Spine Changes in Patients with Obstructive Sleep Apnea Syndrome: A Case Control Study

Özer¹,

Duygulu²,

Terzi³

et al. 2016

J Sleep Disord Ther

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Objective: Recently few studies have described presence of cervical spine anomalies in obstructive sleep apnoea syndrome (OSAS) patients. It is also reported that some cases of cervical spine pathologies and osteophytes producing obstructive sleep apnea. We aim to investigate the prevalence of facet joint arthrosis and degenerative disc disease (DDD) in cervical spine using computed tomography (CT) in OSAS patients. Materials and Methods:We studied on thirty patients with OSAS who had cervical spine CT. Facet joints were evaluated in four grades and scored in 1-4 points by using multiplanar CT images. Disc levels was evaluated by using two-point subjective scale for loss of height, posterior osteophytes, endplate sclerosis, and spinal canal stenosis to determinate DDD. Degeneration of anterior atlanto-odontoid joint (AAOJ) were classified into four grades. Tomographic findings were compared with those for thirty control subjects. Results:The mean degeneration scores of C2-T1 facet joints and C2-C5, C7-T1 disc spaces were significantly higher in the cases of OSAS group than the cases of the control group. There were no significant differences in the mean degeneration scores for C5-6 and C6-7 cervical intervertebral disc levels between the groups. Degeneration scores of the facet and disc for whole cervical spine in the cases of the OSAS group was significantly higher than in cases of the control group (P<0.001 and P=0.002). AAOJ degeneration degrees showed differences between the groups. Statistically significant correlations were found between the OSAS degrees and the intervertebral disc degeneration (R=0.338, P=0.007) and facet joint degeneration (R=0.543, P=0.000) for all cervical vertebrae. Conclusions:The cervical spine of the OSAS patients has more severe disc degeneration and facet joint and AAOJ arthrosis, compared to subjects without OSAS. This findings may contribute to clinic evaluation of OSAS patients with servical pain and limited movement.

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“…A recently developed CT-based classification for facet joint degeneration in the cervical spine showed almost perfect intraobserver reliability. 17 However, in the lumbar spine this grading system was previously shown to have only fair reliability. 16 …”

Section: Discussionmentioning

confidence: 99%

Bone Scans Are Reliable for the Identification of Lumbar Disk and Facet Pathology

Malham

Parker

Ballok

et al. 2014

Global Spine Journal

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Study Design Surgeon survey. Objective To evaluate the reliability of bone single-photon emission computed tomography (SPECT) versus bone SPECT images co-registered with computed tomography (bone SPECT-CT) by analyzing interobserver agreement for identification of the anatomical location of technetium99m-labeled oxidronate uptake in the lumbar disk and/or facet joint. Methods Seven spine surgeons interpreted 20 bone scans: 10 conventional black-and-white tomograms (bone SPECT) and 10 color-graded bone SPECT-CT scans. Each surgeon was asked to identify the location of any diagnostically relevant uptake in the disk and/or facet joint between L1 and S1. Reliability was evaluated using the free-marginal kappa statistic, and the level of agreement was assessed using the Landis and Koch interpretation. Results Conventional bone SPECT scans and bone SPECT-CT scans were reliable for the identification of diagnostically relevant uptake, with bone SPECT-CT having higher reliability (kappa = 0.72) than bone SPECT alone (0.59). Bone SPECT and bone SPECT-CT were also reliable in identifying disk pathology, with kappa values of 0.72 and 0.81, respectively. However, bone SPECT-CT was more reliable (0.81) than bone SPECT (0.60) when identifying facet disease. Conclusions For the identification of disk pathology, it is reasonable to use either conventional bone SPECT or bone SPECT-CT; however, bone SPECT-CT is more reliable for facet joint pathology.

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Facet Joint Degeneration of the Cervical Spine

Cited by 47 publications

References 17 publications

Facet joint disturbance induced by miniscrews in plated cervical laminoplasty

Facet joint disturbance induced by miniscrews in plated cervical laminoplasty

Computed Tomographic Evaluation of Degenerative Spine Changes in Patients with Obstructive Sleep Apnea Syndrome: A Case Control Study

Bone Scans Are Reliable for the Identification of Lumbar Disk and Facet Pathology

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