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.

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.

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 Complications rate and risk factors in unplanned reoperation of degenerative lumbar spondylolisthesis in geriatric patients: a retrospective single-center cohort study of 33 patients

2019 ◽  
Author(s):  
Weiyang Zhong ◽  
Xinjie Liang ◽  
Xiaoji Luo ◽  
Tianji Huang ◽  
Zhengxue Quan
Keyword(s):  
Risk Factors ◽  
Neurological Deficit ◽  
Geriatric Patients ◽  
Significant Difference ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Screw Misplacement ◽  
Group A ◽  
Group B ◽  
Lumbar Spondylolisthesis ◽  
Complications Rate

Abstract Background: The study aimed to investigate the complications rate and risk factors in unplanned reoperation among geriatric patients who underwent posterior lumbar fusion(PLF) for degenerative lumbar spondylolisthesis(DLS).Methods: 1100 DLS patients who were older than 60 years were reviewed from January 2006 to December 2016 and 33 patients underwent unplanned reoperations who were analyzed and divided to two groups(Group A: posteriolateral fusion, Group B: intervertebral fusion). Gender, body mass index (BMI), radiographic data and clinical outcomes data were analyzed to evaluate complications rate and the risk factors for unplanned reoperations.Results: 33 patients were performed by the unplanned reoperations(3%).The patients were followed up for an average of 4.20±2.25 years (Group A)and 4.32±2.54 years(Group B)without significant difference. The significant difference was found in mean age, levels involved levels, hospital stay, surgery time, blood loss between the groups. The causes of unplanned operation were: wound infection, screw misplacement, neurological deficit, nonunion, screw fracture which were significant except the wound infection between the groups. Higher BMI (obesity), diabetes mellitus(DM), more bleeding and gender(female) were the risk factors of the complications. The cases of the screw misplacement, neurological deficit, nonunion and screw fracture in group A were more significantly than in group B.Conclusion: The patients of higher BMI, DM, age, posteriolateral fusion, female predicted higher incidence of unplanned reoperations. The spine surgeons maybe need to pay more attention in their preoperative training and in improving surgical technique which could reduce the reoperation rate.

scholarly journals A Study of Lumbar Disc Herniation and Facet Joint Asymmetry

2019 ◽  
Vol 103 (1-2) ◽  
pp. 87-94
Author(s):  
Qi Lai ◽  
Yuan Liu ◽  
Runsheng Guo ◽  
Xin Lv ◽  
Qiang Wang ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Patients Âgés ◽  
Lower Lumbar Spine ◽  
Significant Difference ◽  
Facet Joint Degeneration ◽  
Disc Herniations ◽  
Lumbar Facet

Purpose: To investigate the association of facet joint asymmetry with lumbar disc herniation at the lower lumbar spine. Methods: A total of 90 patients (ages 18–40 years) with single-level disc herniation (L3–L4, L4–L5, or L5–S1) were included in the study. Facet asymmetry was defined as a difference of 10° in facet joint angles between right and left sides. Normal discs in the same segment of other individuals were used as a control. Patients had facet asymmetry measured for L3 to S1 through 3.0T magnetic resonance imaging, and information was collected, including age, sex, degenerative degree of lumbar facet joints, and the presence or absence of lumbar disc herniation and type. Results: At the L3 to L4 level, 2 cases had facet asymmetry in 8 patients with lumbar disc herniation, compared with 17 cases of facet asymmetry in 82 patients without disc herniation (P = 0.7776, r = 0.030). At the L4 to L5 level, there were 21 cases of facet asymmetry in 45 patients with lumbar disc herniation, compared with 5 cases of asymmetry in 45 patients without disc herniation (P = 0.00019, r = 0.392). At the L5 to S1 level, there were 25 cases of facet asymmetry in 37 patients with lumbar disc herniation, compared with 11 cases of facet asymmetry in 53 patients without disc herniation (P = 0.0000, r = 0.492). There were 23 cases of facet asymmetry in 28 disc herniations of side type compared with 2 cases of facet asymmetry in 9 herniations of center type (P = 0.0008, r = 0.364). There was no significant difference in the relationship between age, facet joint degeneration, and lumbar facet joint asymmetry (P &gt; 0.05). Conclusion: Facet asymmetry is significantly associated with lumbar disc herniation at the L4 to L5 and the L5 to S1 levels, whereas there is an obvious association with the side type of lumbar disc herniation at the L5 to S1 level.

scholarly journals Global sagittal spinal alignment in patients with degenerative low-grade lumbar spondylolisthesis

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901988519
Author(s):  
Hiroto Kobayashi ◽  
Kenji Endo ◽  
Yasunobu Sawaji ◽  
Yuji Matsuoka ◽  
Hirosuke Nishimura ◽  
...  
Keyword(s):  
Sacral Slope ◽  
Low Grade ◽  
Spinal Alignment ◽  
Sagittal Spinal Alignment ◽  
Significant Difference ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis ◽  
Type 3

Purpose: Global sagittal spinal alignment undergoes changes on the basis of sagittal malalignment (trunk inclined forward) in natural degenerative progression. We hypothesized that this change would associate with the disease state of the degenerative lumbar spondylolisthesis (DS). This study aimed to evaluate the global sagittal spinal alignment of low-grade DS by classifying in accordance with sagittal vertical axis (SVA). Methods: The DS group was classified into three types according to the adult spinal deformity classification: type 1, SVA < 40 mm; type 2, 40 mm ≤ SVA < 95 mm; and type 3, 95 mm ≤ SVA. Age and sagittal spinal parameters (thoracic kyphosis, lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI)) were compared among three types. Results: There were statistically significant differences in age, LL, PI, and PT among the three types. In comparison between two types, there was a statistically significant difference between type 1 and type 2 and between type 1 and type 3, but not between type 2 and type 3 in these parameters. PI tended to increase as the type increases. Furthermore, there was significant difference between types 1 and 3. Conclusion: We evaluated the features of the DS types classified by sagittal alignment. Large PI is one of the risk factors for SVA deterioration of DS. PI may be involved in the onset and progression of DS.

Incidence and Risk Factors of Adjacent Cranial Facet Joint Violation Following Pedicle Screw Insertion Using Cortical Bone Trajectory Technique

Spine ◽  
2016 ◽  
Vol 41 (14) ◽  
pp. E851-E856 ◽  
Author(s):  
Keitaro Matsukawa ◽  
Takashi Kato ◽  
Yoshiyuki Yato ◽  
Hiroshi Sasao ◽  
Hideaki Imabayashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cortical Bone ◽  
Pedicle Screw ◽  
Facet Joint ◽  
Cortical Bone Trajectory ◽  
Screw Insertion ◽  
Pedicle Screw Insertion ◽  
Facet Joint Violation

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 Long-term skeletal consequences of childhood acute lymphoblastic leukemia in adult males: a cohort study

2013 ◽  
Vol 168 (2) ◽  
pp. 281-288 ◽  
Author(s):  
O Mäkitie ◽  
R Heikkinen ◽  
S Toiviainen-Salo ◽  
M Henriksson ◽  
L-R Puukko-Viertomies ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Lumbar Spine ◽  
Lymphoblastic Leukemia ◽  
Whole Body ◽  
Compression Fractures ◽  
Lower Lumbar Spine ◽  
Spinal Compression ◽  
Lower Lumbar

ObjectiveLong-term health sequelae of childhood-onset acute lymphoblastic leukemia (ALL) remain largely unknown. Low bone mineral content (BMC) and bone mineral density (BMD) are recognized complications, but it is unknown whether these persist until adulthood. We evaluated skeletal characteristics and their association with ALL therapy in long-term male ALL survivors.DesignThis cross-sectional cohort study included 49 long-term male ALL survivors and 55 age-matched healthy males.MethodsBMD and compression fractures were assessed by dual-energy X-ray absorptiometry; blood biochemistry was obtained for parameters of calcium homeostasis.ResultsThe ALL survivors (median age 29 years, range 25–38 years), assessed 10–38 years after ALL diagnosis, had lower lumbar spine (P<0.001), femoral neck (P<0.001), and whole-body (P=0.017) BMD than expected based on normative values. When compared with the controls (median age 30 years, range 24–36 years), the ALL survivors had lower lumbar spine BMC (P=0.014), lower whole-body BMC (P<0.001), and lower whole-body BMD (P<0.001), but the differences were partly explained by differences in height. Altogether, 20% of the ALL survivors had spinal compression fractures, but these were equally prevalent in the controls. Males diagnosed with ALL before age 5 years had significantly lower BMD values. Other recognized risk factors included untreated hypogonadism, vitamin D deficiency, hypophosphatemia, low IGF-binding protein-3, and low physical activity.ConclusionsAt young adulthood, long-term male ALL survivors have significantly reduced BMC and BMD and a high prevalence of spinal compression fractures. Careful follow-up and active treatment of the recognized risk factors are warranted.

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