Yonsei Med J.  2009 Oct;50(5):624-629. 10.3349/ymj.2009.50.5.624.

Relationship of Facet Tropism with Degeneration and Stability of Functional Spinal Unit

• Kong MH
• He W
• Tsai YD
• Chen NF
• Keorochana G
• Do DH
• Wang JC

• KMID: 1103814
• DOI: http://doi.org/10.3349/ymj.2009.50.5.624

Abstract

PURPOSE
The authors investigated the effect of lumbar facet tropism (FT) on intervertebral disc degeneration (DD), facet joint degeneration (FJD), and segmental translational motion. MATERIALS AND METHODS: Using kinetic MRI (KMRI), lumbar FT, which was defined as a difference in symmetry of more than 7degrees between the orientations of the facet joints, was investigated in 900 functional spinal units (300 subjects) in flexion, neutral, and extension postures. Each segment at L3-L4, L4-L5, and L5-S1 was assessed based on the extent of DD (grade I-V) and FJD (grade 1-4). According to the presence of FT, they were classified into two groups; one with FT and one with facet symmetry. For each group, demographics, DD, FJD and translational segmental motion were compared. RESULTS: The incidence of FT was 34.5% at L3-L4, 35.1% at L4-L5, and 35.2% at L5-S1. Age and gender did not show any significant relationship with FT. Additionally, no correlation was observed between DD and FT. FT, however, wasfound to be associated with a higher incidence of highly degenerated facet joints at L4-L5 when compared to patients without FT (p < 0.01). Finally, FT was not observed to have any effects upon translational segmental motion. CONCLUSION: No significant correlation was observed between lumbar FT and DD or translational segmental motion. However, FT was shown to be associated significantly with the presence of high grades of FJD at L4-L5. This suggests that at active sites of segmental motion, FT may predispose to the development of facet joint degeneration.

Keyword

Facet tropism; disc degeneration; facet joint; lumbar spine

MeSH Terms

Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Female
Humans
Intervertebral Disk Displacement/*etiology/pathology
Joint Diseases/*complications/pathology
Lumbar Vertebrae/*pathology
Magnetic Resonance Imaging
Male
Middle Aged
Sex Factors
Zygapophyseal Joint/*pathology/physiopathology

Figure

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  Fig. 1 Facet angle measurement method. Right facet angle (α) at L3-L4 was measured as the angle between the reference line that passes through the disc center as well as the base of the spinous process and the facet line connecting the anteromedial and posterolateral margins of the superior articular facet.

• 

  Fig. 2 KMRI measurement of segmental translational motion. At L5-S1, vertebral shift of 1.3 mm during flexion (A) and 4.2 mm during extension (B) was measured in KMRI. Based on the measurement calculation, the segmental translational motion was calculated as: 4.2 mm - 1.3 mm = 2.9 mm.

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