Lumbar facet joint osteoarthritis as the underlying reason for persistent low back pain after minimally invasive discectomy

Chen, Zihao; He, Lei; Di, Jiejian; Huang, Lijun; Feng, Feng; Yang, Baofeng; Xie, Peigen; Rong, Limin

doi:10.1007/s00402-022-04595-y

Cited by 10 publications

(10 citation statements)

References 40 publications

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“…Chronic low back pain related to LFJ and IVD degeneration is often resulted from the degeneration, osteoarthritis, and effusion of joints, which are closely related the damage and degeneration of joint cartilage. Although LFJ and IVD degeneration are regarded as common causes of low back pain, it also can be caused by many other reasons [ 5 , 7 , 8 ]. Thus, accurately determining the direct cause of low back pain play an important role in the planning of treatment [ 5 , 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although LFJ and IVD degeneration are regarded as common causes of low back pain, it also can be caused by many other reasons [ 5 , 7 , 8 ]. Thus, accurately determining the direct cause of low back pain play an important role in the planning of treatment [ 5 , 7 , 8 ]. As the level of T2* value can reflect the degree of LFJ and IVD degeneration, it may be useful to help clinicians determine whether the pain comes from LFJ or IVD.…”

Section: Discussionmentioning

confidence: 99%

“…Low back pain is a musculoskeletal disorder that affects up to 60–80% of the population at some point during their lifetime, resulting in considerable negative impacts on quality of life and social economy [ 1 – 4 ]. Both lumbar facet joint (LFJ) osteoarthritis (OA) and intervertebral disc (IVD) degeneration are regarded as common cause of low back pain [ 5 – 8 ]. Thus, it is critical to accurately evaluate the status of LFJ and IVD at different grade of disease process in a reproducible manner.…”

Section: Introductionmentioning

confidence: 99%

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Biochemical changes in lumbar facet joint and disc degeneration by T2* mapping

Ding,

Liu,

Shi

et al. 2024

BMC Musculoskelet Disord

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Background To investigate the biochemical changes in lumbar facet joint (LFJ) and intervertebral disc (IVD) with different degenerative grade by T2* mapping. Methods Sixty-eight patients with low back pain (study group) and 20 volunteers (control group) underwent standard MRI protocols and axial T2* mapping. Morphological evaluation of LFJ and IVD were performed on T2-weighted imaging according to Weishaupt and Pfirrmann grading system, respectively. T2* values of LFJ and of AF (anterior annulus fibrosus), NP (nucleus pulposus), and PF (posterior annulus fibrosus) in IVD were measured. Kruskal-Wallis test and Wilcoxon rank-sum test were used to compare T2* values of subjects with different degenerative grade. Results The mean T2* value of grade 0 LFJ (21.68[17.77,26.13]) was higher than those of grade I (18.42[15.68,21.8], p < 0.001), grade II (18.98[15.56,22.76], p = 0.011) and grade III (18.38[16.05,25.07], p = 0.575) LFJ in study group, and a moderate correlation was observed between T2* value and LFJ grade (rho=-0.304, p < 0.001) in control group. In the analysis of IVD, a moderate correlation was observed between AF T2* value and IVD grade (rho=-0.323, p < 0.001), and between NP T2* value and IVD grade (rho=-0.328, p < 0.001), while no significant difference was observed between the T2* values of PF in IVD of different grade in study group. Conclusions Downward trend of T2* values can be found in LFJ, AF and NP as the degenerative grade rised. But in elderly patients with low back pain, no change trend was found in LFJ due to increased fluid accumulation in the joint space.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Biochemical changes in lumbar facet joint and disc degeneration by T2* mapping

Ding,

Liu,

Shi

et al. 2024

BMC Musculoskelet Disord

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“…The pain is most usually unilateral and limited in irradiation from the joint of origin until the buttocks, more rarely moving down the thigh and mimicking radiculopathy. The cause is often an underlying degenerative process ( 15 ). Osteoarthritis, as a degenerative disease of the joints, has been linked with a higher incidence of LBP among patients operated on for disc herniation, as presented by Chen et al ( 15 ).…”

Section: Mechanical or Intrinsic Spinal Conditionsmentioning

confidence: 99%

“…The cause is often an underlying degenerative process ( 15 ). Osteoarthritis, as a degenerative disease of the joints, has been linked with a higher incidence of LBP among patients operated on for disc herniation, as presented by Chen et al ( 15 ). The authors noted that non-bacterial joint inflammation should be more meticulously examined pre-op since the condition could hinder the actual resolution of the lumbar pain ( 15 ).…”

Section: Mechanical or Intrinsic Spinal Conditionsmentioning

confidence: 99%

Common differential diagnosis of low back pain in contemporary medical practice: a narrative review

Ferdinandov,

Yankov,

Trandzhiev

2024

Front. Med.

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With a wide range of etiologies, low back pain (LBP) presents a true clinical challenge, finding its origins both in intrinsic spinal and systemic conditions, as well as referred ones. This review categorizes the LBP into these three groups and aims to offer a comprehensive look at the tools required to diagnose and differentiate them. The intrinsic etiologies are based on conditions that affect the musculoskeletal components of the lumbar spine, such as intervertebral disc disease, stenosis, muscular imbalance, and facet joint degeneration. The systemic causes usually extend beyond local structures. Such are the cases of neoplasia, infections, and chronic inflammation. The diagnosis is rendered even more complex by adding the referred pain, which only manifests in the lower back yet arises in more distant locations. By synthesizing the literature that encompasses the problem, this review aims to augment the understanding of the differential diagnoses of LBP by showcasing the subject’s nuances. This categorization provides a structured approach to a patient-centered diagnosis, which could facilitate the medical practitioners’ efforts to navigate this pathology more effectively.

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