J Korean Neurosurg Soc.  2015 Oct;58(4):341-345. 10.3340/jkns.2015.58.4.341.

The Effect of the Pedicle-Facet Angle on Degenerative Cervical Spondylolisthesis

• Kim HC
• Jun HS
• Kim JH
• Chang IB
• Song JH
• Oh JK

• KMID: 2114370
• DOI: http://doi.org/10.3340/jkns.2015.58.4.341

Abstract

OBJECTIVE
To measure the orientation of the facet joints of cervical spine (C-spine) segments in the sagittal plane, known as the pedicle-facet (P-F) angle, and to use these measurements to evaluate the relationship between the P-F angle and the amount of vertebral anterolisthesis in patients with degenerative cervical spondylolisthesis (DCS).
METHODS
A retrospective case-control study was performed including 30 age- and sex-matched patients with DCS and 30 control participants. Anterior-posterior and lateral view radiographs of the C-spine were obtained in a standing position. The P-F angle at all cervical levels and the amount of anterolisthesis at C4-5 were measured from lateral view plain radiographs.
RESULTS
The P-F angles at C4-5 were 141.14+/-7.14degrees for the DCS group and 130.53+/-13.50degrees (p=0.012) for the control group, and at C5-6 were 137.46+/-8.53degrees for the DCS group and 128.53+/-16.01degrees for the control group (p=0.001). The mean P-F angle at C4-5 did not correlate with the amount of anterolisthesis (p=0.483). The amount of anterior slippage did correlate with age (p<0.001).
CONCLUSION
The P-F angle was intrinsically higher at C4-5, compared to C5-6, in both the DCS and control groups, which might explain the increased likelihood for anterolisthesis of C4. Higher P-F angles in the DCS group may be a predisposing factor to slippage. The P-F angle may interact with age to increase incidence of anterolisthesis with increasing age.

Keyword

Pedicle facet angle; Facet joints; Degenerative cervical spondylolisthesis; Cervical spine; Facet orientation

MeSH Terms

Case-Control Studies
Causality
Humans
Incidence
Retrospective Studies
Spine
Spondylolisthesis*
Zygapophyseal Joint

Figure

• 

  Fig. 1 A : Lateral radiograph of the cervical spine shows spondylolisthesis at C4-5; horizontal displacement between C4 and C5. B : The pedicle-facet (P-F) angle was defined by the intersection of a straight line connecting the midpoints of the anterior and posterior vertebral cortices and a straight line positioned parallel to the facet joint in the lateral view radiograph (α : the P-F angle).

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