Facet Joints of the Spine: Structure–Function Relationships, Problems and Treatments, and the Potential for Regeneration

O’Leary, Siobhan; Paschos, Nikolaos K.; Link, Jarrett M.; Klineberg, Eric O.; Hu, Jerry C.; Athanasiou, Kyriacos A.

doi:10.1146/annurev-bioeng-062117-120924

Cited by 73 publications

(64 citation statements)

References 165 publications

(183 reference statements)

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“…М. Attur и соавт. [ Тот факт, что у многих пациентов с хронической НБС боль отмечается в покое и ночью и уменьшается после разминки, то есть является воспалительной, может объясняться тем, что причиной ее появления часто становится ОА дугоотростчатых и крестцово-подвздошных суставов, а также остеит позвонков с формированием изменений по типу Modic I [30][31][32].…”

Section: фенотип скелетно-мышечной боли связанный с воспалением («воunclassified

“…Не вызывает сомнений большое значение биомеханических нарушений и при развитии хронической НБС, особенно когда она связана с дегенеративными изменениями межпозвонковых дисков, а также ОА дугоотростчатых и крестцово-подвздошных суставов [30][31][32].…”

Section: фенотип скелетно-мышечной боли связанный с движением («мехаunclassified

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Musculoskeletal pain: determination of clinical phenotypes and the rational treatment approach

Каратеев¹

2019

Alʹm. klin. med.

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Personalized treatment is one of the basic principles of modern medicine. When administering a treatment, one should consider individual patient characteristics, comorbidities and, what is most important, the prevailing symptoms, as well as the clinical phenotype of a disease. This is directly related to chronic musculoskeletal pain (MSP), which occurs with underlying most prevalent joint and vertebral disorders. At present, MSP is considered to be an independent clinical syndrome.Predominant mechanisms of MSP pathophysiology allow for determination of its special phenotypes: “inflammatory”, “mechanical”, related to enthesopathy and central sensitization. Treatment strategies for MSP phenotypes should obviously be differentiated and based on a tailored and pathophysiologically sound of medical agents and non-medical measures with different mechanisms of pharmacological effects. Effective treatment of the “inflammatory” phenotype requires the use of non-steroidal anti-inflammatory drugs, topical glucocorticoids, disease modifying anti-inflammatory agents. The “mechanical” phenotype necessitates the correction of biomechanical abnormalities, the use of hyaluronic acid containing agents, whereas the “enthesopathic” phenotype is treated with local therapy. Treatment of the phenotype with central sensitization is performed with agents effective for neuropathic pain (anticonvulsants, anti-depressants).

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Section: фенотип скелетно-мышечной боли связанный с воспалением («воunclassified

Section: фенотип скелетно-мышечной боли связанный с движением («мехаunclassified

Musculoskeletal pain: determination of clinical phenotypes and the rational treatment approach

Каратеев¹

2019

Alʹm. klin. med.

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“…To avoid assessing the same model used for different clinical scenarios, only original models (with model development presented for the first time) and their validation studies were included in this review. With its focus on methods and validation, this work is complementary to recent reviews on the role of each spinal component in load transmission (Ghezelbash et al 2020), on the structure-function relationship of the facet joints (O'Leary et al 2018), or on finite element analysis of the cervical spine biomechanics (Suarez-Escobar and Rendon-Velez 2018; Kim et al 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Studies have shown association between intervertebral disc degeneration and facet osteoarthritis, even though the latter can exist without the former (Jaumard et al 2011b; Gellhorn et al 2013). Moreover, some disc treatments leading to adjacent disc disease are thought to exacerbate facet osteoarthritis (O'Leary et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Biomechanical modelling of the facet joints: a review of methods and validation processes in finite element analysis

Mengoni

2020

Biomech Model Mechanobiol

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There is an increased interest in studying the biomechanics of the facet joints. For in silico studies, it is therefore important to understand the level of reliability of models for outputs of interest related to the facet joints. In this work, a systematic review of finite element models of multi-level spinal section with facet joints output of interest was performed. The review focused on the methodology used to model the facet joints and its associated validation. From the 110 papers analysed, 18 presented some validation of the facet joints outputs. Validation was done by comparing outputs to literature data, either computational or experimental values; with the major drawback that, when comparing to computational values, the baseline data was rarely validated. Analysis of the modelling methodology showed that there seems to be a compromise made between accuracy of the geometry and nonlinearity of the cartilage behaviour in compression. Most models either used a soft contact representation of the cartilage layer at the joint or included a cartilage layer which was linear elastic. Most concerning, soft contact models usually did not contain much information on the pressure-overclosure law. This review shows that to increase the reliability of in silico model of the spine for facet joints outputs, more needs to be done regarding the description of the methods used to model the facet joints, and the validation for specific outputs of interest needs to be more thorough, with recommendation to systematically share input and output data of validation studies.

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“…Each pair of facet joints in lumbar spine has significant biomechanical contribution to stability and range of motion 5) . Disruption of the integrity of facet joint can lead to significant morbidity to the patient 15) . Fractures of lumbar spine posterior elements usually involved the pedicle or pars articularis.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Resection of Symptomatic Degenerative Repetitive Stress Related Fracture of the Tip of Superior Articular Process. An Unusual Cause of Severe Back Pain: Report of 2 Cases and Technical Note

Kim

Raorane

et al. 2020

J Minim Invasive Spine Surg Tech

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Neglected stress related fracture of superior articular process fracture leading to disability is not commonly reported. Intravertebral foraminal ligament attachment to superior articular process is well described but its repetitive stress related avulsion injury was not reported. The presence of abundant sensory and nociceptive nerve endings around the facet joint can cause significant symptoms in this uncommon condition. We hereby present 2 cases of superior articular process tip fracture. First case is a 53 years old business who presented with intractable chronic back and right gluteal pain for many years worsened with golf games with the diagnosis of nonunion of right L2 superior articular facet and second case is a 74 years old lady who had intractable left buttock and left calf radicular pain with neglected left L5 superior articular facet tip fracture after vertebroplasty treatment on L4 compression fracture; both underwent uniportal endoscopic contralateral approach for decompression and resection of the Superior Articular Process, SAP tip fragment with its attached foraminal ligament with good symptoms relief on one year follow up. Consideration can be made for endoscopic decompression SAP tip fracture in comparison to open decompression or fusion surgery in these symptomatic patients.

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Facet Joints of the Spine: Structure–Function Relationships, Problems and Treatments, and the Potential for Regeneration

Cited by 73 publications

References 165 publications

Musculoskeletal pain: determination of clinical phenotypes and the rational treatment approach

Musculoskeletal pain: determination of clinical phenotypes and the rational treatment approach

Biomechanical modelling of the facet joints: a review of methods and validation processes in finite element analysis

Endoscopic Resection of Symptomatic Degenerative Repetitive Stress Related Fracture of the Tip of Superior Articular Process. An Unusual Cause of Severe Back Pain: Report of 2 Cases and Technical Note

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