Substance P Innervation of Lumbar Spine Facet Joints

OBJECTIVEStereotactic radiosurgery (SRS) has been used to treat trigeminal neuralgia by targeting the cisternal segment of the trigeminal nerve, which in turn triggers changes in the gasserian ganglion. In the lumbar spine, the dorsal root ganglion (DRG) is responsible for transmitting pain sensitivity and is involved in the pathogenesis of peripheral neuropathic pain. Therefore, radiosurgery to the DRG might improve chronic peripheral pain. This study evaluated the clinical and histological effects of high-dose radiosurgery to the DRG in a rodent model.METHODSEight Sprague-Dawley rats received either 40- or 80-Gy SRS to the fifth and sixth lumbar DRGs using the Leksell Gamma Knife Icon. Animals were euthanized 3 months after treatment, and the lumbar spine was dissected and taken for analysis. Simple histology was used to assess collagen deposition and inflammatory response. GFAP, Neu-N, substance P, and internexin were used as a measure of peripheral glial activation, neurogenesis, pain-specific neurotransmission, and neurotransmission in general, respectively. The integrity of the spinothalamic tract was assessed by means of the von Frey test.RESULTSThe animals did not exhibit any signs of motor or sensory deficits during the experimentation period. Edema, fibrosis, and vascular sclerotic changes were present on the treated, but not the control, side. SRS reduced the expression of GFAP without affecting the expression of Neu-N, substance P, or internexin. The von Frey sensory perception elicited equivalent results for the control side and both radiosurgical doses.CONCLUSIONSSRS did not alter sensory or motor function but reduced the activation of satellite glial cells, a pathway for DRG-mediated pain perpetuation. Radiosurgery provoked changes equivalent to the effects of focal radiation on the trigeminal ganglion after SRS for trigeminal neuralgia, suggesting that radiosurgery could be successful in relieving radiculopathic pain.

Download Full-text

The problem of mismatches between CT scan and DXA results

Innovative medicine of Kuban ◽

10.35401/2500-0268-2019-16-4-12-17 ◽

2019 ◽

pp. 12-17

Author(s):

A. E. Bokov ◽

S. G. Mlyavykh ◽

A. A. Bulkin ◽

A. Y. Aleynik ◽

M. V. Rasteryeva

Keyword(s):

Lumbar Spine ◽

Cancellous Bone ◽

Cross Sectional Study ◽

Facet Joints ◽

Mineral Density ◽

Cross Sectional ◽

Property Assessment ◽

Ct Data ◽

The Right ◽

Vertebra Body

Background. It is reported that radiodensity measured in Hounsfield units becomes more and more popular in bone property assessment, however also mismatch with DXA results is observed.Purpose. The aim of this study is to evaluate the relationships between the results of DXA and CT with a focus on explanations for observed discrepancies.Material and methods. This is a cross-sectional study; forty patients were enrolled, all patients underwent DXA and CT. A bone mineral density BMD (g/cm2 ) was calculated for each vertebra of a lumbar spine (L1-L4 inclusive), neck, upper neck, shaft, Wards triangle and trochanter of hip. Bone radiodensity in HU was taken from each vertebral body in the sagittal, axial and coronal planes. A total vertebra body radiodensity including cortical bone and radiodensity of only cancellous bone were calculated. To assess a potential impact on DXA and CT data agreement a mean radiodensity and square of the right and left vertebral pedicles and facet joints were measured for each vertebra.Results. A strong correlation between BMD measured using DXA and CT data was estimated with a multiply r accounting for 0,84169, p<0,0001, however the most contributing parameters were those calculated for facet joints. It has been detected that both radiodensity of only a cancellous bone and total have a weak correlation with matching BMD measurements of a proximal femur.Conclusion. The results of DXA could be strongly influenced by hypertrophic changes of facet joints. Both CT and DXA measurements taken from a lumbar spine may have a mismatch with figures taken from hip.

Download Full-text

Internal morphology of human facet joints: comparing cervical and lumbar spine with regard to age, gender and the vertebral core

Journal of Anatomy ◽

10.1111/j.1469-7580.2011.01465.x ◽

2012 ◽

Vol 220 (3) ◽

pp. 233-241 ◽

Cited By ~ 11

Author(s):

Hans-Joachim Wilke ◽

Daniel Zanker ◽

Uwe Wolfram

Keyword(s):

Lumbar Spine ◽

Facet Joints ◽

Internal Morphology

Download Full-text

Spinal Gas Collection Demonstrated at CT

Acta Radiologica ◽

10.1177/028418519203300202 ◽

1992 ◽

Vol 33 (2) ◽

pp. 93-96 ◽

Cited By ~ 5

Author(s):

J. Hjarbæk ◽

P. W. Kristensen ◽

P. Hauge

Keyword(s):

Lumbar Spine ◽

Epidural Space ◽

Clinical Symptoms ◽

Intervertebral Disk ◽

Surgical Results ◽

Facet Joints ◽

Disk Herniation ◽

Free Gas ◽

Ct Findings

In 234 consecutive CT examinations of the lumbar spine, gas collection was observed in 4 cases with disk herniation, and in 6 cases of disk protrusion. In 3 cases free gas was found in the epidural space, and one patient presented an intraspinal gas-filled “bleb”. Gas collection in intervertebral disk spaces and facet joints was found in a total of 60 patients. The CT findings and surgical results were compared to determine whether gas collection contributes to clinical symptoms. In most cases the presence of gas was not clinically important, but in one patient it presented as a spinal mass, causing pain and radiculopathy.

Download Full-text

Interrelation of tropism and angulation parameters of facet joints and results of stabilization surgeries for degenerative diseases of the lumbar spine

Hirurgiâ pozvonočnika ◽

10.14531/2018.4.70-79 ◽

2018 ◽

Vol 15 (4) ◽

pp. 70-79

Author(s):

V. A. Byvaltsev ◽

A. K. Okoneshnikova ◽

A. A. Kalinin ◽

S. S. Rabinovich

Keyword(s):

Surgical Treatment ◽

Lumbar Spine ◽

Clinical Outcomes ◽

Interbody Fusion ◽

Degenerative Diseases ◽

Facet Joints ◽

Group Iii ◽

Group I ◽

Transpedicular Stabilization

Objective. To clarify indications for dynamic and rigid stabilization based on the analysis of correlation between neuroimaging parameters of facet joints (FJ) and clinical outcomes of surgical treatment of patients with degenerative diseases of the lumbar spine. Material and Methods. A total of 141 patients with degenerative diseases of the lumbar spine were surgically treated. Patients were divided into three groups: patients of Group I (n = 48) underwent surgical intervention with artificial intervertebral disc prosthesis; those of Group II (n = 42) – with interbody fusion and combined transpedicular and transfacetal stabilization; and those of Group III (n = 51) – with interbody fusion and bilateral transpedicular stabilization. The correlation between long-term clinical outcomes (pain syndrome according to VAS, functional state according to ODI, and satisfaction with surgical result according to MacNab scale) and preoperative neuroimaging parameters of FJ (degenerative changes according to Fujiwara, facet angle magnitudes, and the presence of tropism) was analyzed. Results. A direct significant nonparametric correlation of neuroimaging parameters of facet angles and FJ tropism with long-term clinical outcomes of surgical treatment according to VAS and ODI was revealed. It was established that good clinical outcomes were achieved with the following preoperative parameters: in Group I, the facet angle was less than 60°, while the presence of tropism had no correlation dependence; in Group II, the facet angle – more than 60°, in the absence of FJ tropism; and in Group III, the facet angle – more than 60°, in the presence of FJ tropism. Conclusion. Objective neuroimaging parameters of the facet angle magnitude of less than 60°, regardless of the presence of tropism, allow performing total arthroplasty. If the facet angle is more than 60°, the rigid stabilization of the operated segment is indicated; in the absence of tropism, a contralateral transfacetal fixation is possible, and in its presence – a bilateral transpedicular stabilization is reasonable.

Download Full-text

Morphological and radiographic parameters of facet joints and their dependence on the grade of intervertebral disc degeneration

Genij Ortopedii ◽

10.18019/1028-4427-2020-26-4-565-570 ◽

2020 ◽

Vol 26 (4) ◽

pp. 565-570

Author(s):

A.E. Krivoshein ◽

◽

V.P. Konev ◽

S.V. Kolesov ◽

S.N. Moskovsky ◽

...

Keyword(s):

Lumbar Spine ◽

Intervertebral Disk ◽

Tissue Growth ◽

Rigid Fixation ◽

Facet Joints ◽

Grade 5 ◽

Close Relationship ◽

Radiological Changes ◽

Pfirrmann Grade ◽

Bone Structures

Objective To study morphological and radiological parameters of facet joints depending on the grade of the intervertebral disk degeneration. Materials and methods To study the facet joints of the lumbar spine in 145 patients with various grades of degeneration according to Pfirrmann and treated using rigid fixation and TLIF technology, MSCT in 2-energy mode and morphological investigation of the intraoperative material were performed. Results In Pfirrmann grade 2, an increase in the volumetric content of chondrocytes, Hounsfield density of the cartilage plate, and the level of Ca in the facet joints was visualized. They indicate that the joint remains functional. In Pfirrmann grade 5, deep pathological changes occurred with violation of the architectonics of the cartilage formations of the facet joints, formation of bone elements and connective tissue growth into the cartilage and bone structures of the joint, which correlated with the results of MSCT. Conclusion The data obtained show that there is a close relationship between morphological and radiological changes in the facet joints. Modulating the data obtained allows us to obtain objective criteria for evaluating the grade of pathological processes in facet joints and use them as a diagnostic component when planning decompression and stabilizing operations in patients with degenerative diseases of the lumbar spine.

Download Full-text

Correction of post-traumatic kyphosis using intermediate facet joints as fulcrum in dorso-lumbar spine injuries

Indian Journal of Orthopaedics ◽

10.4103/0019-5413.34484 ◽

2006 ◽

Vol 40 (3) ◽

pp. 164

Author(s):

Amit Agrawal ◽

MShantharam Shetty ◽

JP Shetty ◽

U Srikrishna ◽

SwapnilS Nagvenkar

Keyword(s):

Lumbar Spine ◽

Facet Joints ◽

Spine Injuries ◽

Post Traumatic

Download Full-text

Stress Analysis of the Lower Lumbar Spine Three-joint Complex According to Different Pelvic Incidences

10.21203/rs.3.rs-989170/v1 ◽

2021 ◽

Author(s):

Qi Lai ◽

Jun Yin ◽

Zi Zhen Zhang ◽

Jie Yang ◽

Zongmiao Wan

Keyword(s):

Finite Element ◽

Lumbar Spine ◽

Pelvic Incidence ◽

Facet Joint ◽

The Other ◽

Von Mises Stress ◽

Facet Joints ◽

Lower Lumbar Spine ◽

Flexion Extension ◽

Lower Lumbar

Abstract Background: Pelvic incidence is closely related to degeneration of the facet joint and intervertebral disc and is related to the orientation of the facet joints. Currently, very few studies have been conducted on the force analysis of the three-joint complex in patients with different pelvic incidence measurements under different sports postures. We designed this study to better assess the influence of pelvic incidence on the stress of the lumbar three-joint complex. Finite element analysis can provide a biomechanical basis for the relationship between different pelvic incidences and degenerative diseases of the lower lumbar spine.Methods: We developed three nonlinear finite element models of the lumbar spine (L1-S1) with different pelvic incidences (27.44°, 47.05°, and 62.28°) and validated them to study the biomechanical response of facet joints and intervertebral discs with a follower preload of 400 N, under different torques (5 Nm, 10 Nm, and 15 Nm), and compared the stress of the three-joint complex of the lower lumbar spine (L3-S1) in different positions (flexion-extension, left-right bending, and left-right torsion).Results: In the flexion position, the stress of the disc in the low pelvic incidence model was the largest among the three models; the stress of the facet joint in the high pelvic incidence model was the largest among the three groups during the extension position. During torsion, the intradiscal pressure of the high pelvic incidence model was higher than that of the other two models in the L3/4 segment, and the maximum von Mises stress of the annulus fibrosus in the L5/S1 segment with a large pelvic incidence was greater than that of the other two models.Conclusions: Pelvic incidence is related to the occurrence and development of degenerative lumbar diseases. The stress of the lower lumbar facet joints and fibrous annulus of individuals with a high pelvic incidence is greater than that of individuals with a low pelvic incidence or a normal pelvic incidence. Although this condition only occurs in individual segments, to a certain extent, it can also reflect the influence of pelvic incidence on the force of the three-joint complex of the lower lumbar spine.

Download Full-text