POSTERIOR ELEMENT MORPHOLOGY AND DEGENERATIVE LUMBAR SPONDYLOLISTHESIS

2015 ◽  
Vol 18 (01) ◽  
pp. 1550001
Author(s):  
Myung-Sang Moon ◽  
Min-Keun Yoon ◽  
Ki-Tae Kwon ◽  
Min-Suk Park ◽  
Bong-Keun Park ◽  
...  
Keyword(s):  
Inclination Angle ◽  
Facet Joint ◽  
Degenerative Spondylolisthesis ◽  
Predisposing Factor ◽  
Lower Lumbar Spine ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Inclination Angles ◽  
Grade Ii ◽  
Lower Lumbar ◽  
Lumbar Spondylolisthesis

Study design: Retrospective radiographic studies on lumbar facet morphology, and facet and laminar inclination angles. Objectives: To investigate the effect of the facet morphology, facet and laminar inclination angles on development of the segmental instability and spondylolisthesis. Summary of background data: Many previous papers related with the facet shape on pathogenesis of the degenerative instability and spondylolisthesis were published. Most authors interpreted that the facet morphology in the pathogenesis of the spondylolisthesis was a factor secondary to facet joint osteoarthritis, and was not the primary one. None dealt the effect of facet shape and laminar inclination on slippage severity. Method: The subject materials were 50 patients (10 males and 40 females) with degenerative spondylolisthesis, treated between 1999 and 2013. Simple radiograms were utilized for assessment. Facet joints were classified by Tsunoda et al., based on its developmental shape and alignment on radiograms; X, M, and W types. Also the laminar inclination and facet inclination angles were measured. Results: Among 50 patients 45 had anterolisthesis with (forward flexion instability) and only five had retrolisthesis (extension instability). In 45 cases of anterolisthesis, there were 24 "X" types, 4 "M" types, and 17 "W" types, while in 5 cases of retrolisthesis there were 3 "X" and 2 "M" types. In 45 cases of anterolisthesis, 24 with "X" type facets had Myerding's grade I slip, and one had grade II slip; Among the 4 "M" types two had grade I slip and two had grade II slip, while among 17 "W" type, there were four grade I slip, 11 grade II slip, and two grade III slip. 13 out of the 16 anterolisthesis over grade II slip had "W" type facets. Vertebra with "W" type facets had average 130° laminar inclination angle and 122° facet inclination angles, while "X" and "M" type facets had less inclination of both angles. Conclusion: The defective facet morphology and laminar inclination angle of the lower lumbar spine can be the predisposing factor of development and slip progress of the degenerative anterolisthesis.

scholarly journals Multivariate analysis of pedicle screw invasion of the proximal facet joint after lumbar surgery

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Peng Tao Wang ◽  
Jia Nan Zhang ◽  
Tuan Jiang Liu ◽  
Jun Song Yang ◽  
Ding Jun Hao
Keyword(s):  
Risk Factors ◽  
Pedicle Screw ◽  
Joint Angle ◽  
Facet Joint ◽  
Lumbar Surgery ◽  
Lower Lumbar Spine ◽  
Significant Difference ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lower Lumbar ◽  
Lumbar Spondylolisthesis

Abstract Background To analyze the risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery. Methods From January 2019 to January 2021, 1794 patients with lumbar degenerative disease, such as lumbar disc herniation, lumbar spinal stenosis and lumbar spondylolisthesis, were treated at our hospital. In all, 1221 cases were included. General data (sex, age, BMI), bone mineral density, proximal facet joint angle, degenerative lumbar spondylolisthesis, isthmic lumbar spondylolisthesis and fixed segment in the two groups were recorded. After the operation, vertebral CT of the corresponding surgical segments was performed for three-dimensional reconstruction and evaluation of whether the vertebral arch root screw interfered with the proximal facet joint. The included cases were divided into an invasion group and a noninvasion group. Univariate analysis was used to screen the risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery, and the selected risk factors were included in the logistic model for multivariate analysis. Results The single-factor analysis showed a significant difference in age, BMI, proximal facet joint angle, degenerative lumbar spondylolisthesis, and fixed segment (P < 0.1). Multifactor analysis of the logistic model showed a significant difference for age ≥ 50 years (P < 0.001, OR = 2.291), BMI > 28 kg/m2 (P < 0.001, OR = 2.548), degenerative lumbar spondylolisthesis (P < 0.001, OR = 2.187), gorge cleft lumbar relaxation (P < 0.001, OR = 2.410), proximal facet joint angle (35 ~ 45°: P < 0.001, OR = 3.151; > 45°: P < 0.001, OR = 3.578), and fixed segment (lower lumbar spine: P < 0.001, OR = 2.912). Conclusion Age (≥ 50 years old), BMI (> 28 kg/m2), proximal facet joint angle (35 ~ 45°, > 45°), degenerative lumbar spondylolisthesis, isthmic lumbar spondylolisthesis and fixed segment (lower lumbar spine) are independent risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery. Compared with degenerative lumbar spondylolisthesis, facet joint intrusion is more likely in isthmic lumbar spondylolisthesis.

Predictors of L4−L5 Degenerative Lumbar Spondylolisthesis: L4 Inclination Angle and Facet Joint Angle

2019 ◽  
Vol 130 ◽  
pp. e680-e686 ◽  
Author(s):  
Machao Guo ◽  
Chao Kong ◽  
Siyuan Sun ◽  
Xiangyao Sun ◽  
Xiangyu Li ◽  
...  
Keyword(s):  
Inclination Angle ◽  
Joint Angle ◽  
Facet Joint ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis

scholarly journals Association of Lumbar Paraspinal Muscle Morphometry with Degenerative Spondylolisthesis

2021 ◽  
Vol 18 (8) ◽  
pp. 4037
Author(s):  
Eun Taek Lee ◽  
Seung Ah Lee ◽  
Yunsoo Soh ◽  
Myung Chul Yoo ◽  
Jun Ho Lee ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Protective Factor ◽  
Degenerative Spondylolisthesis ◽  
Fatty Degeneration ◽  
Erector Spinae ◽  
Cross Sectional ◽  
Skeletal Muscle Index ◽  
Fat Infiltration ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis

The objective of this study was to assess the cross-sectional areas (CSA) of lumbar paraspinal muscles and their fatty degeneration in adults with degenerative lumbar spondylolisthesis (DLS) diagnosed with chronic radiculopathy, compare them with those of the same age- and sex-related groups with radiculopathy, and evaluate their correlations and the changes observed on magnetic resonance imaging (MRI). This retrospective study included 62 female patients aged 65–85 years, who were diagnosed with lumbar polyradiculopathy. The patients were divided into two groups: 30 patients with spondylolisthesis and 32 patients without spondylolisthesis. We calculated the CSA and fatty degeneration of the erector spinae (ES) and multifidus (MF) on axial T2-weighted magnetic resonance (MR) images from the inferior end plate of the L4 vertebral body levels. The functional CSA (FCSA): CSA ratio, skeletal muscle index (SMI), and MF CSA: ES CSA ratio were calculated and compared between the two groups using an independent t-test. We performed logistic regression analysis using spondylolisthesis as the dependent variable and SMI, FCSA, rFCSA, fat infiltration rate as independent variables. The result showed more fat infiltration of MF in patients with DLS (56.33 vs. 44.66%; p = 0.001). The mean FCSA (783.33 vs. 666.22 mm2; p = 0.028) of ES muscle was a statistically larger in the patients with DLS. The ES FCSA / total CSA was an independent predictor of lumbar spondylolisthesis (odd ratio =1.092, p = 0.016), while the MF FCSA / total CSA was an independent protective factor (odd ratio =0.898, p = 0.002)

What is the Effect of Lumbar Medial Branch Nerve Radiofrequency Ablation on Lumbar Spondylolisthesis: A Single-Center, Observational Study

2021 ◽  
Author(s):  
Trusharth Patel ◽  
Christopher Watterson ◽  
Anne Marie McKenzie-Brown ◽  
Boris Spektor ◽  
Katherine Egan ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Degenerative Spondylolisthesis ◽  
Lumbar Pain ◽  
Spinal Instability ◽  
Medial Branch ◽  
Single Center ◽  
Spine Imaging ◽  
Grade Ii ◽  
Lumbar Spondylolisthesis

Abstract Background Radiofrequency ablation (RFA) is a denervation therapy commonly performed for pain of facet etiology. Degenerative spondylolisthesis, a malalignment of the spinal vertebrae, may be a co-existing condition contributing to pain; yet the effect of RFA on advancing listhesis is unknown. To the extent that denervating RFA can weaken paraspinal muscles that provide stability to the spine, the therapy can potentially contribute to progressive spinal instability. Objectives To test the hypothesis that RFA of painful facets in the setting of spondylolisthesis may contribute to advancement of further degenerative spondylolisthesis. Methods Single-center, prospective, observational pilot study in an interventional pain practice. Fifteen participants with pre-existing degenerative Grade I or Grade II spondylolisthesis and coexisting axial lumbar pain underwent lumbar RFA encompassing spondylolisthesis level and followed with post-RFA imaging at 12 months and beyond to measure percent change in spondylolisthesis. Results The primary outcome was the percent advancement of spondylolisthesis per year measured on post-RFA lateral lumbar spine imaging compared to non-intervention baseline advancement of 2.6% per limited observational studies. Among the 15 participants enrolled, 14 completed the study (median age 66; 64.3% women; median BMI 33.5; mean follow-up time 23.9 months). The mean advancement of spondylolisthesis per year after RFA was 1.30% (95% CI -0.14 to 2.78%), with 9/14 below 1.25%. Conclusion Among patients with lumbar pain originating from facets in the setting of degenerative spondylolisthesis who underwent lumbar RFA, the observed advancement of spondylolisthesis is clinically similar to the baseline of 2.6% per year change. The study findings did not find a destabilizing effect of lumbar RFA in advancing spondylolisthesis in this patient population.

scholarly journals Hyperlordosis is Associated With Facet Joint Pathology at the Lower Lumbar Spine

2017 ◽  
Vol 30 (3) ◽  
pp. 129-135 ◽  
Author(s):  
Thorsten Jentzsch ◽  
James Geiger ◽  
Matthias A. König ◽  
Clément M.L. Werner
Keyword(s):  
Lumbar Spine ◽  
Facet Joint ◽  
Joint Pathology ◽  
Lower Lumbar Spine ◽  
Lower Lumbar

scholarly journals Effect of Lumbar Medial Branch Nerve Radiofrequency Ablation on Lumbar Spondylolisthesis

2020 ◽  
Author(s):  
Trusharth Patel ◽  
Christopher Watterson ◽  
Anne Marie McKenzie-Brown ◽  
Boris Spektor ◽  
Katherine Egan ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Degenerative Spondylolisthesis ◽  
Lumbar Pain ◽  
Medial Branch ◽  
Academic Center ◽  
Spine Imaging ◽  
Grade Ii ◽  
The Mean ◽  
Lumbar Spondylolisthesis

AbstractImportanceRadiofrequency ablation (RFA) is a denervation therapy commonly performed for pain of facet etiology. Degenerative spondylolisthesis may be a co-existing condition; yet the effect of RFA on advancing listhesis is unknown.ObjectiveTo test the hypothesis that RFA of painful facets in the setting of spondylolisthesis may contribute to advancement of further degenerative spondylolisthesis.DesignRetrospective and prospective, observational study conducted at a single academic center among 15 participants with pre-existing degenerative Grade I or Grade II spondylolisthesis undergoing lumbar RFA encompassing spondylolisthesis level and followed with post-RFA imaging at 12 months and beyond to measure percent change in spondylolisthesis.Main Outcomes and MeasuresThe primary outcome was the percent advancement of spondylolisthesis per year measured on post-RFA lateral lumbar spine imaging compared to non-intervention baseline advancement of 2.6% per limited observational studies.ResultsAmong the 15 participants enrolled, 14 completed the study (median age 66; 64.3% women; median BMI 33.5; mean follow-up time 23.9 months). The mean advancement of spondylolisthesis per year after RFA was 1.30% (95% CI −0.14 to 2.78%), with 9/14 below 1.25%.Conclusion and RelevanceAmong patients with lumbar pain originating from facets in the setting of degenerative spondylolisthesis who underwent lumbar RFA, the observed advancement of spondylolisthesis is clinically similar to the baseline of 2.6% per year change. The study findings did not find a destabilizing effect of lumbar RFA in advancing spondylolisthesis in this patient population.

101 Lumbar Fusion Versus Laminectomy for Spondylolisthesis: Lessons Learned from the AANS/CNS Spine Section Study Group's Analysis of the N2QOD Registry

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 219-220
Author(s):  
Erica Fay Bisson ◽  
Mohamad Bydon ◽  
Michael S Virk ◽  
Steven D Glassman ◽  
Kevin T Foley ◽  
...  
Keyword(s):  
Back Pain ◽  
Lumbar Fusion ◽  
Degenerative Spondylolisthesis ◽  
Leg Pain ◽  
Absolute Difference ◽  
Section Study ◽  
Pain Scores ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis ◽  
Level Fusion

Abstract INTRODUCTION The AANS/CNS Spine Section Study Group analyzed 12-month outcomes data from for patients undergoing either laminectomy with fusion or laminectomy alone for grade 1 degenerative spondylolisthesis at ten sites. METHODS 475 patients undergoing elective spine surgery for degenerative grade 1 lumbar spondylolisthesis were identified by retrospective analysis of prospectively collected data from the QOD spine registry. Patients with more than one level fusion were excluded (n = 121) leaving a 354 patient cohort. Patients undergoing 1 level fusion with 1–3 levels of laminectomy (n = 274) were compared to those undergoing 1–3 levels of laminectomy alone (n = 80). RESULTS >For patients presenting with Grade1 spondylolisthesis, 23% (80/354) underwent laminectomy alone while 77% (274/354) underwent 1 level fusion with laminectomy. The percentage of cases returning to the OR within one year was similar for the laminectomy (6.2%) versus the fusion group (6.9%). At baseline, the fusion group had higher NRS back pain (7.0 ± 2.4 vs 5.94 ± 3.0, P< 0.01) and ODI (46.2 ± 15.3 vs 36.8 ± 16.3, P< 0.001) scores than the laminectomy alone group, however, NRS leg pain scores were equivalent. When comparing absolute difference in outcomes at 12-months to baseline, NRS back pain (4.1 ± 2.9 vs 3.1 ± 3.5, P = 0.05) and ODI (25.7 ± 16 vs 19.0 ± 17, P< 0.01) scores improved to a greater extent in the fusion group compared to laminectomy alone group whereas NRS leg pain scores improved equally. Patient satisfaction scores were equivalent for both surgical groups. CONCLUSION The data indicate that fusion with laminectomy for grade 1 degenerative lumbar spondylolisthesis is associated with low readmission and re-operation rates. Patients in the laminectomy with fusion group report more baseline back pain (NRS-back pain) and disability (ODI). Patients undergoing fusion with laminectomy report greater improvement in back pain and less disability at 12-months as compared to those in the lam group, while both groups had equivalent improvement in leg pain.

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