Facet joint parameters which may act as risk factors for chronic low back pain

Yang, Ming; Wang, Naiguo; Xu, Xiaoxin; Xu, Gang; Chang, Yvang

doi:10.1186/s13018-020-01706-6

Cited by 16 publications

(10 citation statements)

References 40 publications

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“…However, in other studies, facet asymmetry was significantly related to lumbar stenosis, 14 spondylolisthesis, 26 and low back pain. 25 In this study, FJ tropism was not strongly correlated with FJ OA but was a risk factor for LFS. This seems to be a combination of the abovementioned views.…”

Section: Discussioncontrasting

confidence: 49%

“…23 Studies on young populations have demonstrated that coronal orientation of the FJ is a risk factor for disc herniation and low back pain. 24,25 This evidence indicated that as lumbar degeneration progressed, the FJs were remodeled to a sagittal orientation to reduce loading. However, further studies are required to identify these pathological changes.…”

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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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

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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“… 47 - 49 After CDA surgery, the kinematic and biomechanical changes could have adverse effects on the facet joints, 32 , 50 , 51 and the non-physical stress on the facet joints could result in facetogenic neck pain, especially in asymmetric 3-joint complex. 22 , 52 Differences in pain may account for the decreased C2-C7 ROM in the asymmetric group. Whereas, clinical scores showed no difference between symmetric and asymmetric groups in our study.…”

Section: Discussionmentioning

confidence: 99%

Effect of Facet Tropism on Postoperative Cervical Range of Motion After Single-Level Cervical Disc Arthroplasty

Liu

Xiao

Líu

et al. 2021

Global Spine Journal

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Study Design: Retrospective analysis. Objectives: Cervical disc arthroplasty (CDA) was designed to replace the degenerated disc with the prosthesis to preserve cervical motion. The commonly used artificial discs are designed symmetric, whereas the facet joints were reported to be asymmetric in many people. This study aimed to evaluate the effect of facet tropism on the cervical range of motion (ROM) after single-level CDA using Prestige LP. Methods: A total of 90 patients who underwent single-level CDA using Prestige LP from 2012 to 2017 were retrospectively reviewed. Radiographs were taken at each time point to measure the C2-C7 ROM and the ROM at the surgical segment. The pre-operation CT scans were utilized to reconstruct and calculate the angular direction of facet joints with respect to transverse, coronal, and sagittal reference planes. Facet tropism above 7° was defined as facet joint asymmetry. Results: No significant difference was found in flexion-extension C2-C7 ROM or ROM at the surgical segment between patients with symmetric and asymmetric fact joints regarding the sagittal plane. Patients with coronal asymmetric facet joints had lower flexion-extension ROM at the surgical level. Patients with transverse asymmetric facet joints had both lower flexion-extension C2-C7 ROM and ROM at the surgical level. After CDA surgery, patients obtained good clinical outcomes including increased Japanese Orthopedic Association (JOA) and decreased Neck Disability Index (NDI) as well as Visual Analogue Scale (VAS). Conclusion: The coronal and transverse tropism seemed to be correlated with decreased flexion-extension ROM after CDA using Prestige LP.

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“…Linov et al 36 confirmed a significant association between sagittal orientation and OA of the LFJ at level L4-L5 in a cross-sectional study. Yang et al 37 demonstrated that FJT may play an important role in the pathogenesis of lumbar degenerative diseases, using finite element analysis and contour maps visualization. Ke et al 38 found that the combination of FJO and FJT played an important role in the development of lumbar degeneration, including disc and LFJ.…”

Section: Pathogenesismentioning

confidence: 99%

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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Facet joint parameters which may act as risk factors for chronic low back pain

Cited by 16 publications

References 40 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

Effect of Facet Tropism on Postoperative Cervical Range of Motion After Single-Level Cervical Disc Arthroplasty

Facet Joint Syndrome: Pathophysiology, Diagnosis, and Treatment

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