scholarly journals Spine Degeneration and Inflammation

2021 ◽  
pp. 197-213
Author(s):  
David J. Wilson ◽  
Marcelo de Abreu
Keyword(s):  
Ankylosing Spondylitis ◽  
Facet Joint ◽  
Joint Disease ◽  
Disc Disease ◽  
Inflammatory Disorders ◽  
Degenerative Disorders ◽  
Dynamic Function ◽  
Spine Degeneration ◽  
As Stress ◽  
Effective Diagnosis

AbstractConventional radiographs and CT are primary investigations in spinal trauma. However MRI is the primary technique in the assessment of degenerative and inflammatory disorders. There are occasions when conventional radiographs, CT and bone scintigraphy assist in the diagnosis of degenerative and inflammatory disorders.A detailed understanding of anatomy and spine dynamic function is essential in the interpretation of imaging.Degenerative disorders including disc disease sometimes result in neural compression, facet joint and costovertebral arthropathy which is also potentially associated with spinal stenosis and neural compression. Scheuermann described a disorder with template irregularity that mimics degenerative disorders but is a genetic condition. Pars interarticularis stress fractures were once thought to be congenital in origin but are now regarded as stress injuries occurring in adolescence potentially leading to lifelong spondylolisthesis.Inflammatory joint disease is not just ankylosing spondylitis. There are a range of disorders, and the reporting practitioner must understand and appreciate the symptoms and signs on images. The early diagnosis of inflammatory arthropathy especially ankylosing spondylitis is essential in the effective management of the disease. Imaging is a major component of an accurate and effective diagnosis.

Posterior Epidural Migration of Sequestrated Lumbar Disc Fragments Into the Bilateral Facet Joints

Neurosurgery ◽  
2011 ◽  
Vol 69 (5) ◽  
pp. E1148-E1151 ◽  
Author(s):  
Tzuu-Yuan Huang ◽  
Kung-Shing Lee ◽  
Tai-Hsin Tsai ◽  
Yu-Feng Su ◽  
Shiuh-Lin Hwang
Keyword(s):  
Differential Diagnosis ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Synovial Cyst ◽  
Leg Pain ◽  
Hybrid Technique ◽  
Facet Joints ◽  
Disc Disease ◽  
First Case ◽  
Rod System

Abstract BACKGROUND AND IMPORTANCE Symptomatic lumbar disc herniation is common. Migration of a free disc fragment is usually found in rostral, caudal, or lateral directions. Posterior epidural migration is very rare. We report the first case with posterior epidural migration and sequestration into bilateral facet joints of a free disc fragment. CLINICAL PRESENTATION A 78-year-old female presented with low back pain and right leg pain. Plain radiographs showed lumbar spondylolisthesis. Magnetic resonance imaging revealed a posterior epidural mass and intrafacet mass, which was hypointense on T1-weighted images and hyperintense on T2-weighted images. The lesion in the left L3-4 facet joint had rim enhancement, whereas the right one was not contrasted after gadolinium injection. Preoperative differential diagnosis included abscess, tumor, hematoma, or synovial cyst. An interbody cage fusion at L3-4 and L4-5 for spondylolisthesis was performed, and a hybrid technique was applied with the Dynesys flexible rod system at L3-S1 for multisegment degenerative disc disease. The lesion proved to be an epidural disc fragment with sequestration into bilateral facet joints. CONCLUSION A free disc fragment should be considered in the differential diagnosis of posterior epidural lesions, and even in the facet joint.

scholarly journals The appropriate hybrid surgical strategy in three-level cervical degenerative disc disease: a finite element analysis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Y. M. Xie ◽  
Y. C. Zheng ◽  
S. J. Qiu ◽  
K. Q. Gong ◽  
Y. Duan
Keyword(s):  
Stress Distribution ◽  
Facet Joint ◽  
Ultrahigh Molecular Weight Polyethylene ◽  
Fe Model ◽  
Hybrid Surgery ◽  
Disc Disease ◽  
Element Analysis ◽  
Intact Group ◽  
Joint Force ◽  
3D Ct Scan

Abstract Objective The purpose of this FE study was to analyze the biomechanical characteristics of different HS strategies used in the treatment of three-level CDDD (one-level CDA and two-level ACDF). Methods We validated the FE model of an intact cervical spine established by transferring the data, collected by 3D CT scan, to the FE software ABAQUS and comparing these data with the data from published studies. Then, the FE model of hybrid surgery was reconstructed to analyze the range of motion (ROM), facet joint force, and stress distribution on an ultrahigh molecular weight polyethylene (UHMWPE) core. Results The current cervical FE model was able to measure the biomechanical changes in a follow-up hybrid surgery simulation. The total ROM of the cervical HS models was substantially decreased compared with the total ROM of the intact group, and the M2 (C3/4 ACDF, C4/5 CDA, and C5/6 ACDF) model had the closest total ROM to the intact group, but the facet joint force adjacent to the treatment levels showed very little difference among them. The stress distribution showed noticeable similarity: two flanks were observed in the center core, but the inlay of M2 was more vulnerable. Conclusions Through the comparison of ROM, the facet joint force after CDA, and the stress distribution of the prosthesis, we find that M2 model has a better theoretical outcome, especially in preserving the maximum total ROM.

scholarly journals Lumbar stenosis: indications for fusion with and without instrumentation

1997 ◽  
Vol 3 (2) ◽  
pp. E6 ◽  
Author(s):  
Paul W. Detwiler ◽  
Frederick F. Marciano ◽  
Randall W. Porter ◽  
Volker K. H. Sonntag
Keyword(s):  
Facet Joint ◽  
Dynamic Instability ◽  
Lumbar Fusion ◽  
Rapid Development ◽  
Degenerative Spondylolisthesis ◽  
Lumbar Stenosis ◽  
Disc Disease ◽  
Diagnostic Categories ◽  
Number Of Factors ◽  
Failed Back Surgery

Although the efficacy of posterior decompression for symptomatic lumbar stenosis that is recalcitrant to conservative therapy is well proven, uniform agreement on the need for simultaneous arthrodesis is lacking. The variability in the rate of lumbar fusion with and without instrumentation has been attributed to a number of factors: advances in surgical technique; rapid development of instrumentation; radiographic advances in the diagnosis of disease entities of the lumbar spine; evolution in our understanding of bone healing; improved pre- and postoperative care; aggressive rehabilitation; patient compensation; hospital and surgeon reimbursement; better education of residents, fellows, and practicing neurosurgeons; and, most important, the lack of clear indications based on defined diagnostic categories. Based on review of the literature and their experience at the Barrow Neurological Institute, the authors have attempted to define indications for lumbar fusion with or without instrumentation based on defined diagnostic categories. Clear indications for fusion include trauma, tumor, or infection with two- or three-column injury, iatrogenic instability, and isthmic spondylolisthesis. Relative indications for fusion include degenerative spondylolisthesis, radiographically proven dynamic instability with pain or neurological findings, adult scoliosis, and mechanical back pain. Fusion is rarely indicated with discectomy, abnormal radiographs without appropriate findings (such as degenerative disc disease), facet joint syndrome, failed back surgery, or stable spinal stenosis.

scholarly journals Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Andrew M. Felstead ◽  
Peter J. Revington
Keyword(s):  
Ankylosing Spondylitis ◽  
Bone Loss ◽  
Temporomandibular Joint ◽  
Surgical Procedures ◽  
Total Joint Replacement ◽  
Joint Disease ◽  
Inflammatory Joint Disease ◽  
Degenerative Osteoarthritis ◽  
Temporomandibular Joint Ankylosis ◽  
Joint Ankylosis

Relatively few patients develop such severe degenerative temporomandibular joint (TMJ) disease that they require total joint replacement. Current indications include those conditions involving condylar bone loss such as degenerative (osteoarthritis) or inflammatory joint disease (ankylosing spondylitis, rheumatoid, and psoriatic). Ankylosis of the temporomandibular joint (TMJ) secondary to ankylosing spondylitis remains an under investigated entity. We aim to provide an overview of treatment objectives, surgical procedures, and our experience with total TMJ replacement for this condition.

Lumbar Spine Capsule Strain After Total Disc Replacement

2010 ◽  
Author(s):  
Tomoyuki Takigawa ◽  
Alejandro A. Espinoza Orías ◽  
Howard S. An ◽  
Peter Simon ◽  
Keizo Sugisaki ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Facet Joint ◽  
Total Disc Replacement ◽  
Clinical Results ◽  
Disc Replacement ◽  
Segmental Motion ◽  
Low Back ◽  
Disc Disease ◽  
Poor Outcomes

Degenerative disc disease is a common cause for low back pain, and sometimes requires surgical treatment. Total disc replacement (TDR) is one such surgical option performed to remove the painful disc and preserve segmental motion. However, TDR clinical results are not always satisfactory. Altered kinematics and residual low back pain have been reported as frequent poor outcomes. The facet joint is a pure articular joint and can be a pain generator. Although the effect of TDR on ROMs (ranges of motion) and facet contact force is relatively well studied, the influence of TDR on facet capsules has not been clarified yet. The purpose of this study was to evaluate the effect of TDR on facet joint capsule strain.

Application of CT Image Based on Three-Dimensional Image Segmentation Algorithm in Diagnosis of Osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
pp. 230-234
Author(s):  
Songlin Liu ◽  
Dasheng Gai ◽  
Qun Lu ◽  
Hanyuan Zhang ◽  
Xu Kuang ◽  
...  
Keyword(s):  
Facet Joint ◽  
Articular Surface ◽  
Three Dimensional ◽  
Spiral Ct ◽  
Joint Space ◽  
Joint Disease ◽  
Facet Joints ◽  
Surface Destruction ◽  
Lumbar Facet ◽  
Image Segmentation Algorithm

Objective: To investigate the application of multi-slice spiral CT in degenerative changes of lumbar facet joints using the LOG algorithm. Methods: The CT findings of 100 cases of degenerative vertebral facet joint disease were reviewed and analyzed in this paper. Results: The main CT manifestations of facet disease are osteophyte formation, articular hyperplasia and hypertrophy, osteosclerosis, narrowing of joint space, articular surface destruction, joint capsule calcification, joint gas accumulation, joint subluxation, and lateral recesses and vertebrae. Signs such as narrow mesopores. Conclusion: The multi-slice spiral CT (MSCT) and multi-planar reconstruction (MPR) techniques are analyzed by the LOG operator algorithm. It is found that the two techniques can fully display the anatomical structure and pathological changes of the vertebral facet joints, and are useful for the diagnosis of facet joint disease. Provide enough imaging evidence.

Aromatase inhibitor (AI)-associated arthralgia (A) and bone pain (BP): Frequency and characterization in clinical practice

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6137-6137 ◽  
Author(s):  
C. A. Presant ◽  
C. Kelly ◽  
L. Bosserman ◽  
G. Upadhyaya ◽  
M. Vakil ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Bone Pain ◽  
Pain Scale ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Consecutive Series ◽  
Disc Disease ◽  
Cancer Centers ◽  
Age Range ◽  
And Control

6137 Background: Prior studies of AI have identified A and/or BP as side effects. Reported incidences have varied from 4% (IMPACT) to 35.6% (ATAC). In order to determine the frequency of A or BP in clinical practice, we reviewed a consecutive series of patients (PTs) receiving AI in community cancer centers. Methods: The charts of consecutive PTs receiving AI were reviewed, and PTs were interviewed regarding the occurrence of A or BP (ABP), severity, whether ABP was worse than before AI therapy, preexisting co-morbidities, type of therapy for ABP, and pain characterization. Results: 56 PTs were receiving AI. The type of AI used was anastrazole in 44 PTs, letrozole in 10 PTs, and exemestane in 2 PTs. The age range was 45 to 89 years. All PTs had breast cancer. The duration AI usage was 1 to 44 mo. Worsening of ABP compared to pretreatment ABP was reported in 34 PTs (61%). In 11 Pts (20%), severity was sufficient and control poor enough to result in discontinuation of AI at a median of 2 mo of AI therapy. The median severity of ABP, when present, was 7.5 on a 10 point pain scale. The character of the ABP was continuous in 20 (59%) and intermittent in 14 (41%), affected central/axial bones in 20 (36%), and peripheral bones in 35 (64%). Coexisting conditions possibly contributing to worsening of ABP occurred in 36%, consisting of degenerative joint disease 10, fibromyalgia 1, osteoporosis 4, and degenerative disc disease 1. Therapy associated with amelioration of symptoms included acetaminophen in 26%, NSAIDs in 45%, mild opiates in 11%, strong opiates in 5%, and glucosamine in 13%. The occurrence of ABP was not associated with age (68% in PTs less than 60 versus 57% in PTs over 60). The occurrence of ABP was not associated with duration of use of AI (50% of 16 Pts on AI for 3–6 mo, 75% for 7–12 mo, and 56% for over 12 mo). Conclusions: The occurrence of AI associated ABP is higher in a non-clinical trial population of PTs than reported in most clinical trials. This side effect is severe enough to cause discontinuation of needed AI therapy in 20%. Further studies are warranted to determine the mechanism of AI associated ABP, and optimal therapy. It is reasonable to consider glucosamine as well as standard analgesics in controlling this syndrome. No significant financial relationships to disclose.

Patterns of Peripheral Joint Disease in Ankylosing Spondylitis

Radiology ◽  
1974 ◽  
Vol 110 (3) ◽  
pp. 523-532 ◽  
Author(s):  
Donald Resnick
Keyword(s):  
Ankylosing Spondylitis ◽  
Joint Disease

scholarly journals Effect of multiple cervical facet joint intra-articular steroid injection for early mobilization of cervical spine in early cervical predominant ankylosing spondylitis

KYAMC Journal ◽  
2018 ◽  
Vol 9 (1) ◽  
pp. 39-40
Author(s):  
Mohammad Moniruzzaman ◽  
Md Shahadat Hossain ◽  
Muhammad Alamgir Mandal ◽  
Md Zakir Hossain ◽  
Md Ahsan Ullah ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Inflammatory Reaction ◽  
Local Anesthetic ◽  
Facet Joint ◽  
Steroid Injection ◽  
Facet Joints ◽  
Vicious Cycle ◽  
Image Guided ◽  
Cervical Facet ◽  
Cervical Facet Joint

Background: Ankylosing spondylitis (AS) have also been described as causes of facet joint pain. Image-guided injection of local anesthetic and steroid into the facet joint aims to break this vicious cycle and stop the inflammatory reaction involving facet joints in AS.Objectives: Image-guided injection of local anesthetic and steroid into the facet joint aims to break this vicious cycle and stop the inflammatory reaction involving facet joints in AS.Materials & Methods: Obtaining an informed consent, the procedure was performed with strict aseptic precautions and intra-procedural vital parameters were monitored.Results: After 7 days of extensive rehabilitation program, the ROM in all direction was dramatically improved with significant improvement of pain. Regarding VAS, during 1st visit it was 8, after 30 min of injection the score became 6 (25% improvement) and after one week, the score became 2 (75% improvement).Conclusion: Multiple intra-articular cervical facet joint steroid injection is very much effective in acute facet joint synovitis in cervical predominant early AS for starting early rehabilitation program.KYAMC Journal Vol. 9, No.-1, April 2018, Page 39-40

Impairment Rating for Non-Specific Back Pain Under the AMA Guides, Sixth Edition: Medical Perspective

2014 ◽  
Vol 19 (2) ◽  
pp. 3-6 ◽  
Author(s):  
James B. Talmage ◽  
Jay Blaisdell ◽  
Marjorie Eskay-Auerbach ◽  
Christopher R. Brigham
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Examination ◽  
Chronic Back Pain ◽  
Facet Joint ◽  
Spinal Pain ◽  
Low Back ◽  
Disc Disease ◽  
Sixth Edition ◽  
Recurrent Low Back Pain

Abstract Low back pain and disability are common and evaluating a patient with non-specific spinal pain may be challenging, including determining impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, provides ratable impairment for the diagnosis of “non-specific chronic, or chronic recurrent low back pain (also known as chronic sprain/strain, symptomatic degenerative disc disease, facet joint pain,” and others. The evaluator should consider the diagnosis of non-specific chronic back pain only when no category of specific diagnosis fits the case (eg, no fracture, no spinal stenosis) or when “no reliable physical examination or imaging findings” but the patient's history of pain is felt to be reliable. According to the AMA Guides, primary determinant between a class 0 and class 1 rating for non-specific chronic back pain is whether the evaluator gives credibility to the patient's subjective reports of pain and interference with activities of daily living (ADLs). An evaluator may choose to use the Pain Disability Questionnaire (reproduced in the article) and Table 17-6, Functional History Adjustment, Spine, to determine the Functional History Grade Modifier (GMFH). The diagnosis of non-specific chronic or chronic recurrent low back pain yields a positive impairment only when the evaluator feels the patient's pain, as quantified by the GMFH, is reliably reported. Because there are no diagnostic objective findings on physical examination or clinical studies, these modifiers are excluded.

Sign in / Sign up

Export Citation Format

Share Document