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Soydan Z, Bayramoglu E, Altas O. The Impact of Spinopelvic Alignment on the Facet Joint Degeneration. Global Spine J 2025; 15:306-313. [PMID: 36893076 PMCID: PMC11877576 DOI: 10.1177/21925682231162813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
STUDY DESIGN Retrospective Cohort. OBJECTIVES This study aims to evaluate the relations between facet joint degeneration (FD) and sagittal spinopelvic parameters. Second, the association of FD with degenerative disc disease (DDD) and lumbar disc herniations (LDH) was assessed. METHODS The radiologic data of 192 patients was retrospectively analyzed. Total, proximal, and distal lumbar lordosis (LL, PLL, and DLL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and sacral table angle (STA) were measured on lumbar x-ray plates. DDD and FD was graded on the MRI images. The apex of lumbar lordosis and PI-LL imbalance were noted in each patient. Correlation analyses were performed. RESULTS Age and body mass index (BMI) were correlated with FD. LL and DLL are positively associated with upper-level FDs (L1-2 and L2-3) (P < 0,05). PLL were positively associated with lower level FD (L5-S1) (P < 0,05). A significant increase in PI was associated with FD in L2-3 and L4-5. A larger PT was found in FD in L4. The PI-LL imbalance was not correlated with the FD. Correlation between DDD and LDH and FD was observed in each level (P < 0,01). The level of FD is not affected by the apex of the curve. CONCLUSION Age and BMI have a direct impact on FD. However, spinopelvic parameters influence the severity of FD rather than its occurrence. In addition to the effects of lumbar lordosis as a single entity, it is essential to consider separately the effects of proximal and distal lumbar lordosis at the FD level.
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Affiliation(s)
- Zafer Soydan
- Department of Orthopaedics and Traumatology, Bhtclinic İstanbul Tema Hospital, Nisantasi University, Istanbul, Turkey
| | - Emru Bayramoglu
- Orthopedics and Traumatology, Bursa City Hospital, Istanbul, Turkey
| | - Okyar Altas
- Orthopaedics and Traumatology, Basaksehir Cam Sakura City Hospital, Istanbul, Turkey
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Ishihama Y, Tezuka F, Manabe H, Morimoto M, Yamashita K, Sakai T, Sairyo K. Facet Joint Morphology and Tropism in Adolescents: Association With Lumbar Disk Herniation and Spondylolysis. Spine (Phila Pa 1976) 2024; 49:1029-1035. [PMID: 37661834 DOI: 10.1097/brs.0000000000004818] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/22/2023] [Indexed: 09/05/2023]
Abstract
STUDY DESIGN A cross-sectional and observational study. OBJECTIVE To investigate the incidence of bidirectional lumbar facet tropism and its relationship with lumbar spine disease in adolescents. SUMMARY OF BACKGROUND DATA There is limited information on facet joint asymmetry in the sagittal plane in adolescents. MATERIALS AND METHODS The orientation of all lumbar facet joints was measured in the bidirectional planes on computed tomographic images for 191 patients with low back pain. The patients were divided into 4 groups according to age (<15 or ≥15 yr) and sex. The facet joint angle and tropism rate were compared among the groups. Facet tropism was defined as a difference in bilateral angle of >10° in the axial plane and >5° in the sagittal plane. Facet joint orientation was compared among groups using a one-way analysis of variance and Tukey honestly significant difference test or Games-Howell post hoc test and the incidence of facet tropism using the Kruskal-Wallis test with Bonferroni correction. The association of facet tropism with disease was investigated further by analyzing facet joint orientation and the incidence of facet tropism in 116 patients with single-level lumbar disease. RESULTS Facet tropism was observed in 8.7% of axial views and 7.5% of sagittal views. The incidence of axial facet tropism was significantly higher in male patients aged ≥15 years, especially at L4/5. Facet joint morphology in the axial plane was more coronal at L3/4 and L4/5 in male patients ≥15 years than in those <15 years. Facet joint morphology in the sagittal plane was unchanged at around 15 years of age in both sexes. Axial facet tropism was found at L4/5 in 55.6% of patients with herniated nucleus pulposus. There was a significant difference in sagittal facet orientation in patients with spondylolysis at L5. The facet angle was significantly larger in patients with L5 spondylolysis at L3/4 and L4/5. CONCLUSIONS Facet tropism in adolescents is similar in the axial and sagittal planes. Facet tropism and specific morphology may be related to lumbar disk herniation and spondylolysis in this age group.
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Affiliation(s)
- Yoshihiro Ishihama
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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Du R, Xu G, Bai X, Li Z. Facet Joint Syndrome: Pathophysiology, Diagnosis, and Treatment. J Pain Res 2022; 15:3689-3710. [PMID: 36474960 PMCID: PMC9719706 DOI: 10.2147/jpr.s389602] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/17/2022] [Indexed: 11/16/2023] Open
Abstract
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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Affiliation(s)
- Ruihuan Du
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Gang Xu
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Dalian, People’s Republic of China
| | - Xujue Bai
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Zhonghai Li
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Dalian, People’s Republic of China
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Quantitative evaluation of correlation between lumbosacral lordosis and pelvic incidence in standing position among asymptomatic Asian adults: a prospective study. Sci Rep 2022; 12:18965. [PMID: 36347920 PMCID: PMC9643535 DOI: 10.1038/s41598-022-21840-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 10/04/2022] [Indexed: 11/11/2022] Open
Abstract
The determination of lumbopelvic alignment is essential for planning adult spinal deformity surgery and for ensuring favorable surgical outcomes. This prospective study investigated the correlation between the lumbar section of lumbar spine lordosis and increasing pelvic incidence in 324 Asian adults with a mean age of 55 ± 13 years (range: 20-80 years), comprising 115 male and 209 female volunteers. Participants were divided into three groups based on pelvic incidence (G1, G2, and G3 had pelvic incidence of < 45°, 45-55°, and ≥ 55°, respectively). We determined that distal and proximal lumbar lordosis contributed differentially to the increase in pelvic incidence, whereas the lordosis ratio of the L3-L4 and L4-L5 segments mostly remained constant. The mean contribution ratio of the segmental lordosis from L1 to S1 was as follows: L1-L2, 2.3%; L2-L3, 11.7%; L3-L4, 18.1%; L4-L5, 25.2%; and L5-S1, 42.7%. Pelvic incidence had a stronger correlation with proximal lumbar lordosis than did distal lumbar lordosis. The ratios of proximal lumbar lordosis to distal lumbar lordosis were 37.8% in G1, 45.8% in G2, and 55.9% in G3. These findings serve as a reference for future lumbar spine correction or fusion surgery for Asian adults.
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Kobayashi T, Morimoto T, Yoshihara T, Sonohata M, Rivière C, Mawatari M. The significant relationship among the factors of pelvic incidence, standing lumbar lordosis, and lumbar flexibility in Japanese patients with hip osteoarthritis: A descriptive radiographic study. Orthop Traumatol Surg Res 2022; 108:103123. [PMID: 34700058 DOI: 10.1016/j.otsr.2021.103123] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 04/23/2021] [Accepted: 07/12/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Spine stiffness is known to increase the risk of total hip replacement (THR) instability. The sagittal posture and lumbo-pelvic kinematics have therefore become parameters of interest when planning THR. We conducted this study to investigate (1) the distribution and characteristics of the spino-pelvic standing alignment, (2) the relationship between pelvic incidence (PI) and standing lumbar lordosis (LL) and lumbar flexibility, in Japanese hip osteoarthritis patients. HYPOTHESIS (1) Japanese hip osteoarthritis patients with different sagittal spino-pelvic alignments do not differ markedly in their demographics, PI, or lumbar flexibility; and (2) there is no significant relationship between PI, standing LL, and lumbar flexibility in a population of Japanese hip osteoarthritis patients. MATERIAL AND METHODS A retrospective study of radiographs from 945 Japanese patients who consecutively received THR for the treatment of hip osteoarthritis. All patients pre-operatively underwent lateral standing and deep-seated lumbo-pelvic radiography on which the spino-pelvic parameters were measured. The difference between the standing and deep-seated LL angles defined the lumbar flexibility and was calculated as the delta (Δ) LL. Individual spino-pelvic standing alignment was stratified based on the difference between the PI and standing LL ('PI-LL mismatch'). 'PI-LL mismatch' of<-10°, between -10° and 10°, and>10° was defined as hyperlordosis, normolordosis, and flatback, respectively. RESULTS In the present study, the spinal alignment of 115/945 (12.2%), 559/945 (59.2%), and 271/945 (28.6%) patients were classified as hyperlordosis, normolordosis, and flatback, respectively. Hyperlordotic patients had significantly lower PI (47.6°±7.8° vs. 52.7°±10.5°, p<0.001) and higher ΔLL (60.6°±12.6° vs. 51.6°±12.8°, p<0.001) than normolordotic patients. Patients with flatback were significantly older (age, 69.1±9.1 years vs. 62.7±9.8 years, p<0.001) with higher PI (56.9°±11.7° vs. 52.7°±10.5°, p<0.001) and lower ΔLL (35.2°±17.4° vs. 51.6°±12.8°, p<0.001) than normolordotic patients. A significant relationship between PI and the standing LL was found in the whole cohort (r=0.409, p=0.009), hyperlordotic (r=0.785, p<0.001), normolordotic (r=0.857, p<0.001), and flatback (r=0.664, p<0.001) patients. Significant relationships between the PI and ΔLL were also found in normolordotic (r=0.442, p=0.004) and flatback (r=0.449, p=0.003) patients but not hyperlordotic patients (r=0.154, p=0.367). DISCUSSION A large proportion of Japanese hip osteoarthritis patients have abnormal PI-LL mismatch (12% and 29% have hyperlordosis and flatback, respectively). The PI was a determinant of the standing LL and the lumbar flexibility, especially in the normolordotic and flatback individuals. LEVEL OF EVIDENCE III; retrospective diagnostic radiographic study.
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Affiliation(s)
- Takaomi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 8498501, Japan.
| | - Tadatsugu Morimoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 8498501, Japan
| | - Tomohito Yoshihara
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 8498501, Japan
| | - Motoki Sonohata
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 8498501, Japan
| | - Charles Rivière
- MSK Lab - Imperial College London, White City Campus, London, UK; The Lister Hospital, Chelsea Bridge, London, UK; Centre de l'Arthrose, Bordeaux-Mérignac, France
| | - Masaaki Mawatari
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 8498501, Japan
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Kobayashi T, Morimoto T, Otani K, Mawatari M. Locomotive Syndrome and Lumbar Spine Disease: A Systematic Review. J Clin Med 2022; 11:jcm11051304. [PMID: 35268395 PMCID: PMC8911455 DOI: 10.3390/jcm11051304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/21/2022] [Accepted: 02/25/2022] [Indexed: 02/04/2023] Open
Abstract
Locomotive syndrome (LS) is defined based on the Loco-Check, 25-question Geriatric Locomotive Function Scale (GLFS-25), 5-question Geriatric Locomotive Function Scale (GLFS-5), Stand-Up Test, Two-Step Test, or a total assessment (i.e., positive for one or more of the GLFS-25, Stand-Up Test, and Two-Step Test). Lumbar spine disease has been reported to be one of the most common musculoskeletal disorders leading to LS. We therefore conducted a systematic review via PubMed, Google Scholar, Cochrane Library, Web of Science, and MEDLINE, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 26 studies were considered to be eligible for inclusion in this systematic review. The GLFS-25 showed an association with low back pain, sagittal spinopelvic malalignment, and lumbar spinal stenosis but not vertebral fracture. The GLFS-5 showed an association with low back pain and lumbar spinal stenosis. The Loco-Check and Two-Step Test showed an association with low back pain, sagittal spinopelvic malalignment, and lumbar spinal stenosis. The Stand-Up Test showed no association with lumbar spinal stenosis. The total assessment showed an association with low back pain and lumbar spinal stenosis. Furthermore, the GLFS-25, Two-Step Test, and total assessment were improved by spinal surgery for lumbar spinal stenosis. The current evidence concerning the relationship between LS and lumbar spine disease still seems insufficient, so further investigations are required on this topic.
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Affiliation(s)
- Takaomi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (T.K.); (M.M.)
| | - Tadatsugu Morimoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (T.K.); (M.M.)
- Correspondence: ; Tel.: +81-952-34-2343; Fax: +81-952-34-2059
| | - Koji Otani
- Department of Orthopaedic Surgery, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan;
| | - Masaaki Mawatari
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (T.K.); (M.M.)
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Iwasa M, Ando W, Uemura K, Hamada H, Takao M, Sugano N. Pelvic incidence is not associated with the development of hip osteoarthritis. Bone Joint J 2021; 103-B:1656-1661. [PMID: 34719275 DOI: 10.1302/0301-620x.103b11.bjj-2021-0472.r1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Pelvic incidence (PI) is considered an important anatomical parameter for determining the sagittal balance of the spine. The contribution of an abnormal PI to hip osteoarthritis (OA) remains controversial. In this study, we aimed to investigate the relationship between PI and hip OA, and the difference in PI between hip OA without anatomical abnormalities (primary OA) and hip OA with developmental dysplasia of the hip (DDH-OA). METHODS In this study, 100 patients each of primary OA, DDH-OA, and control subjects with no history of hip disease were included. CT images were used to measure PI, sagittal femoral head coverage, α angle, and acetabular anteversion. PI was also subdivided into three categories: high PI (larger than 64.0°), medium PI (42.0° to 64.0°), and low PI (less than 42.0°). The anterior centre edge angles, posterior centre edge angles, and total sagittal femoral head coverage were measured. The correlations between PI and sagittal femoral head coverage, α angle, and acetabular anteversion were examined. RESULTS No significant difference in PI was observed between the three groups. There was no significant difference between the groups in terms of the category distribution of PI. The DDH-OA group had lower mean sagittal femoral head coverage than the other groups. There were no significant correlations between PI and other anatomical factors, including sagittal femoral head coverage, α angle, and acetabular anteversion. CONCLUSION No associations were found between mean PI values or PI categories and hip OA. Furthermore, there was no difference in PI between patients with primary OA and DDH-OA. From our evaluation, we found no evidence of PI being an independent factor associated with the development of hip OA. Cite this article: Bone Joint J 2021;103-B(11):1656-1661.
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Affiliation(s)
- Makoto Iwasa
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Wataru Ando
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Keisuke Uemura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hidetoshi Hamada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masaki Takao
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Nobuhiko Sugano
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
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Chou PH, Lin HH, Yao YC, Wang ST, Chang MC, Liu CL. Preoperative facet joint arthropathy does not impact long-term clinical outcomes after lumbar-stability-preserving decompression and dynesys fixation. Sci Rep 2021; 11:11299. [PMID: 34050251 PMCID: PMC8163830 DOI: 10.1038/s41598-021-90967-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 05/19/2021] [Indexed: 11/09/2022] Open
Abstract
To evaluate the impact of the preoperative severity of facet joint arthropathy on long-term functional outcomes and spinopelvic parameters in patients undergoing lumbar-stability-preserving decompression and Dynesys fixation. In this retrospective study, 88 patients undergoing combined surgery at our hospital from 2008 to 2015 were included. The patients were divided into two groups, the less and more than mean degeneration groups, based on preoperative facet joint arthropathy of the index level(s). The clinical outcomes were the Visual Analogue Scale (VAS) score, the Oswestry Disability Index (ODI) score and spinopelvic parameters. The mean follow-up durations for the less and more than mean degeneration groups were 84.83 ± 27.58 and 92.83 ± 20.45 months, respectively. The combined surgery significantly improved VAS and ODI scores, and increased sacral slope (SS) regardless of preoperative arthropathy severity. In addition, facet joint arthropathy at adjacent levels continued to worsen after surgery in both arthropathy severity groups. Preoperative facet joint arthropathy did not influence most long-term clinical outcomes in patients undergoing lumbar-stability-preserving decompression and Dynesys fixation. This combined surgery may be suitable for patients with facet joint arthropathy regardless of disease severity.
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Affiliation(s)
- Po-Hsin Chou
- School of Medicine, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Beitou District, Taipei, 112, Taiwan, ROC. .,Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, 18F, 201, Section 2, Shipai Road, Beitou District, Taipei, 112, Taiwan, ROC.
| | - Hsi-Hsien Lin
- School of Medicine, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Beitou District, Taipei, 112, Taiwan, ROC.,Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, 18F, 201, Section 2, Shipai Road, Beitou District, Taipei, 112, Taiwan, ROC
| | - Yu-Cheng Yao
- School of Medicine, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Beitou District, Taipei, 112, Taiwan, ROC.,Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, 18F, 201, Section 2, Shipai Road, Beitou District, Taipei, 112, Taiwan, ROC
| | - Shih-Tien Wang
- School of Medicine, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Beitou District, Taipei, 112, Taiwan, ROC.,Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, 18F, 201, Section 2, Shipai Road, Beitou District, Taipei, 112, Taiwan, ROC
| | - Ming-Chau Chang
- School of Medicine, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Beitou District, Taipei, 112, Taiwan, ROC.,Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, 18F, 201, Section 2, Shipai Road, Beitou District, Taipei, 112, Taiwan, ROC
| | - Chien-Lin Liu
- School of Medicine, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Beitou District, Taipei, 112, Taiwan, ROC.,Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, 18F, 201, Section 2, Shipai Road, Beitou District, Taipei, 112, Taiwan, ROC
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Comment on Imai et al.: Evaluation of pelvic morphology in female patients with developmental dysplasia of the hip using three-dimensional computed tomography: A cross-sectional study. J Orthop Sci 2021; 26:322-323. [PMID: 33451874 DOI: 10.1016/j.jos.2020.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/09/2020] [Indexed: 11/23/2022]
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10
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Yin J, Liu Z, Li C, Luo S, Lai Q, Wang S, Zhang B, Wan Z. Effect of facet-joint degeneration on the in vivo motion of the lower lumbar spine. J Orthop Surg Res 2020; 15:340. [PMID: 32819395 PMCID: PMC7439653 DOI: 10.1186/s13018-020-01826-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/29/2020] [Indexed: 11/10/2022] Open
Abstract
Objective This research studied the in vivo motion characteristics of the L3–S1 lumbar spine with facet-joint degeneration during functional activities. Methods Thirteen male and 21 female patients with facet-joint degeneration at the L3–S1 spinal region were included in the study. The L3–S1 lumbar segments of all the patients were divided into 3 groups according to the degree of facet-joints degeneration (mild, moderate, or severe). The ranges of motion (ROM) of the vertebrae were analyzed using a combination of computed tomography and dual fluoroscopic imaging techniques. During functional postures, the ROMs were compared between the 3 groups at each spinal level (L3–L4, L4–L5, and L5–S1). Results At L3–L4 level, the primary rotations between the mild and moderate groups during left-right twisting activity were significantly different. At L4–L5 level, the primary rotation of the moderate group was significantly higher than the other groups during flexion-extension. During left-right bending activities, a significant difference was observed only between the moderate and severe groups. At L5–S1 level, the rotation of the moderate group was significantly higher than the mild group during left-right bending activity. Conclusions Degeneration of the facet joint alters the ROMs of the lumbar spine. As the degree of facet-joint degeneration increased, the ROMs of the lumbar vertebra that had initially increased declined. However, when there was severe facet-joint degeneration, the ROMs of the lumbar spine declined to levels comparative to the moderate group. The relationship between the stability of the lumbar vertebra and the degree of facet-joint degeneration requires further study.
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Affiliation(s)
- Jun Yin
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, 17 Yongwai Street, Nanchang, Jiangxi, 330006, PR China
| | - Zhang Liu
- Science and Technology Office, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China
| | - Chao Li
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, 17 Yongwai Street, Nanchang, Jiangxi, 330006, PR China
| | - Shiwei Luo
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, 17 Yongwai Street, Nanchang, Jiangxi, 330006, PR China
| | - Qi Lai
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, 17 Yongwai Street, Nanchang, Jiangxi, 330006, PR China
| | - Shaobai Wang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Bin Zhang
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, 17 Yongwai Street, Nanchang, Jiangxi, 330006, PR China
| | - Zongmiao Wan
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, 17 Yongwai Street, Nanchang, Jiangxi, 330006, PR China.
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Zhu K, Su Q, Chen T, Zhang J, Yang M, Pan J, Wan W, Zhang A, Tan J. Association between lumbar disc herniation and facet joint osteoarthritis. BMC Musculoskelet Disord 2020; 21:56. [PMID: 31996194 PMCID: PMC6990568 DOI: 10.1186/s12891-020-3070-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 01/15/2020] [Indexed: 01/02/2023] Open
Abstract
Background This study was performed to investigate the association between lumbar disc herniation (LDH) and facet joint osteoarthritis (FJOA) using magnetic resonance imaging (MRI). Methods Between March 2012 and September 2018, a total of 441 segments from 394 patients with LDH were included in the study. LDH was classified according to the Michigan State University (MSU) classification, in which the degree of LDH is divided into 3 levels (expressed as 1, 2, and 3) and the location of LDH is divided into 4 zones (described as A, AB, B, and C). Bilateral FJOA was graded from 0 to 3 using the criteria introduced by Weishaupt et al., and bilateral facet orientations were measured on axial MRI slices. A mixed-effects ordinal logistic regression model was utilized to determine the potential factors that may be associated with FJOA, including sex, age, body mass index (BMI), segment, facet orientation and tropism, and the degree and location of LDH. Results In general, the prevalence of FJOA (grade ≥ 2) was 66.2% in LDH segments. For both the left and right sides, the degree of LDH was associated with the severity of FJOA (p < 0.01). Age and BMI were also associated with the severity of left and right FJOA (p = 0.002 and p < 0.001 for age, p < 0.001 and p = 0.003 for BMI, respectively), while segment, facet orientation, and facet tropism were not (p > 0.05 for all). Notably, MSU-B LDH was associated with greater odds of having more severe FJOA on the herniation side (left: p < 0.001, odds ratio (OR) = 2.714, 95% confidence interval (CI) = 1.583~4.650; right: p = 0.003, OR = 2.615, 95% CI = 1.405~4.870). However, other locations of LDH were not associated with the severity of FJOA (p > 0.05 for all). Conclusions Both the degree of LDH and MSU-B LDH are associated with the severity of FJOA. The association between LDH and FJOA highlights the complexity of the etiology of FJOA.
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Affiliation(s)
- Kai Zhu
- Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, No.150 Jimo Road, Shanghai, 200120, China
| | - Qihang Su
- Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, No.150 Jimo Road, Shanghai, 200120, China
| | - Tao Chen
- Department of Orthopedics, Shanghai Tongji Hospital, Tongji University School of Medicine, No.389 Xincun Road, Shanghai, 200092, China
| | - Jinbiao Zhang
- Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, No.150 Jimo Road, Shanghai, 200120, China
| | - Mingjie Yang
- Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, No.150 Jimo Road, Shanghai, 200120, China
| | - Jie Pan
- Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, No.150 Jimo Road, Shanghai, 200120, China
| | - Weiping Wan
- Department of Radiology, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China
| | - Aihong Zhang
- Department of Medical Statistics, Tongji University School of Medicine, No.1239 Siping Road, Shanghai, 200092, China.
| | - Jun Tan
- Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, No.150 Jimo Road, Shanghai, 200120, China. .,Department of Orthopedics, Pinghu Second People's Hospital, Pinghu, 314200, China.
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12
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Incidence and Risk Factors for Facet Joint Violation in Open Versus Minimally Invasive Procedures During Pedicle Screw Placement in Patients with Trauma. World Neurosurg 2018; 112:e711-e718. [DOI: 10.1016/j.wneu.2018.01.138] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/16/2018] [Accepted: 01/17/2018] [Indexed: 11/20/2022]
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13
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Comparative Analysis of Bone Structural Parameters Reveals Subchondral Cortical Plate Resorption and Increased Trabecular Bone Remodeling in Human Facet Joint Osteoarthritis. Int J Mol Sci 2018. [PMID: 29538299 PMCID: PMC5877706 DOI: 10.3390/ijms19030845] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Facet joint osteoarthritis is a prominent feature of degenerative spine disorders, highly prevalent in ageing populations, and considered a major cause for chronic lower back pain. Since there is no targeted pharmacological therapy, clinical management of disease includes analgesic or surgical treatment. The specific cellular, molecular, and structural changes underpinning facet joint osteoarthritis remain largely elusive. The aim of this study was to determine osteoarthritis-related structural alterations in cortical and trabecular subchondral bone compartments. To this end, we conducted comparative micro computed tomography analysis in healthy (n = 15) and osteoarthritic (n = 22) lumbar facet joints. In osteoarthritic joints, subchondral cortical plate thickness and porosity were significantly reduced. The trabecular compartment displayed a 42 percent increase in bone volume fraction due to an increase in trabecular number, but not trabecular thickness. Bone structural alterations were associated with radiological osteoarthritis severity, mildly age-dependent but not gender-dependent. There was a lack of association between structural parameters of cortical and trabecular compartments in healthy and osteoarthritic specimens. The specific structural alterations suggest elevated subchondral bone resorption and turnover as a potential treatment target in facet joint osteoarthritis.
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