Facet Tropism and Orientation: Risk Factors for Degenerative Lumbar Spinal Stenosis

Abstract

The aim of this study is to establish whether facet tropism (FT) and orientation (FO) are associated with degenerative lumbar spinal stenosis (DLSS). A retrospective computerized tomography (CT) study including 274 individuals was divided into two groups: control (82 males and 81 females) and stenosis (59 males and 52 females). All participants have undergone high-resolution CT scan of the lumbar spine in the same position. FT and FO were measured at L1-2 to L5-S1. Significant sagittal FO was noted in the stenosis males (L2-3 to L4-5) and females (L2-3 to L5-S1) compared to the controls. The prevalence of FT was remarkably greater in the stenosis males (L4-5, L5-S1) and females (L3-4, L5-S1) compared to their counterparts in the control group. Our results also showed that FT (L3-4 to L5-S1) increases approximately 2.9 times the likelihood for DLSS development. This study indicates that FO and FT in the lower lumbar spine are significantly associated with DLSS.

Lumbar Spinal Stenosis: Pathophysiology and Treatment Principle: A Narrative Review

“…In addition, calcification or thickening of the yellow ligament is an important mechanism in stenosis. Joint tropism can also be a factor leading to degenerative lumbar spinal stenosis [ 7 ]. Consequently, this causes the stenosis of the spinal canal and compression of nerve structures, which may lead to intermittent neurogenic claudication due to congestion of the epidural venous blood and increased vascular pressure.…”

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

“…Kalichman 18 considered that the relationship between FJ tropism and FJ OA was “false positive” because facet tropism could only indicate that one side had more severe OA than that of the other. 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.…”

“…FJ orientation and tropism have been proposed to reflect the degeneration and reconstruction of the FJ. [12][13][14] In other studies, the superior articular process cross-sectional area (SAPA) 15,16 and FJ area 17 were considered good indicators for evaluating patients with degenerative lumbar spinal stenosis. Lim 16 proposed the SAPA as a predictor of LFS.…”

Clinical Outcomes and Quality of Life in Elderly Patients Treated with a Newly Designed Double Tube Endoscopy for Degenerative Lumbar Spinal Stenosis

“…Degenerative lumbar spinal stenosis (DLSS) is usually associated with degenerative changes in intervertebral discs, zygapophyseal joints, and ligamentum flava and osteophyte formation 1 . DLSS usually occurs in the elderly population and causes a poor quality of life, especially in individuals older than 60 years of the age 2 .…”

“…Degenerative lumbar spinal stenosis (DLSS) is usually associated with degenerative changes in intervertebral discs, zygapophyseal joints, and ligamentum flava and osteophyte formation. 1 DLSS usually occurs in the elderly population and causes a poor quality of life, especially in individuals older than 60 years of the age. 2 The number of people over 60 years of the age is projected to increase to 2 billion before 2050 because of the decreasing fertility rate and increasing life expectancy.…”