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

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.

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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.

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COMPARATIVE ANALYSIS OF RADIOLOGIC ASPECTS OF FACET JOINTS IN SURGICAL TREATMENT OF PATIENTS WITH DEGENERATIVE DISEASES OF THE LUMBAR SPINE

Innovative medicine of Kuban ◽

10.35401/2500-0268-2021-21-1-14-20 ◽

2021 ◽

pp. 14-20

Author(s):

A. Ye. Krivoshein ◽

V. P. Konev ◽

S. V. Kolesov ◽

S. N. Moskovsky

Keyword(s):

Computed Tomography ◽

Surgical Treatment ◽

Lumbar Spine ◽

Rigid Fixation ◽

Facet Joints ◽

Affected Area ◽

Results Of Treatment ◽

Group I ◽

Adjacent Segments ◽

Patient Studies

Objective To study the radiologic characteristics of facet joints at different stages of the degenerative process in the lumbar spine to determine the indications for various methods of fixing the affected segment and to evaluate the results of treatment.Material and Methods To determine the radiologic aspects of facet joints in the affected area and in adjacent segments of the lumbar spine, two groups were formed, including 136 patients who underwent multispiral computed tomography in two-energy mode before surgery and 12 months after surgery. Group I included patients who underwent rigid fixation of the spine (360°), and group II included patients who underwent dynamic fixation using nitinol rods (180°).Results Based on a comprehensive instrumental study, it was found that the degeneration of the intervertebral disc according to Pfirrmann II and III revealed an increase in the density of the cartilaginous plate in facet joints (HU). These digital indicators confirm the preservation of joint functionality, both in the affected area and in adjacent segments. With severe degrees of disk degeneration in Pfirrmann IV and V and facet joints, deep pathological changes occurred, directed towards the loss of facet joints functionality.Conclusion The obtained digital indicators of dual-energy computed tomography for the state of facet joints in combination with the results of magnetic resonance imaging can be used as criteria in a complex of patient studies to assess the degree of degeneration of the vertebral motion segment in the affected area and adjacent segments. We recommend using these criteria as a diagnostic component for finding optimal methods of surgical treatment.

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MR imaging of the lumbar spine: prevalence of intervertebral disk extrusion and sequestration, nerve root compression, end plate abnormalities, and osteoarthritis of the facet joints in asymptomatic volunteers.

Radiology ◽

10.1148/radiology.209.3.9844656 ◽

1998 ◽

Vol 209 (3) ◽

pp. 661-666 ◽

Cited By ~ 325

Author(s):

D Weishaupt ◽

M Zanetti ◽

J Hodler ◽

N Boos

Keyword(s):

Lumbar Spine ◽

Mr Imaging ◽

Nerve Root ◽

Intervertebral Disk ◽

Nerve Root Compression ◽

Facet Joints ◽

End Plate ◽

Asymptomatic Volunteers

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Hybrid Rigid-Deformable Model for Prediction of Neighboring Intervertebral Disk Loads During Flexion Movement After Lumbar Interbody Fusion at L3–4 Level

Journal of Biomechanical Engineering ◽

10.1115/1.4035483 ◽

2017 ◽

Vol 139 (3) ◽

Author(s):

Tien Tuan Dao

Keyword(s):

Lumbar Spine ◽

Computational Models ◽

Interbody Fusion ◽

Clinical Decision ◽

Intervertebral Disk ◽

Design Guideline ◽

Spinal Loads ◽

Stress Changes ◽

Stress Behaviors

Knowledge of spinal loads in neighboring disks after interbody fusion plays an important role in the clinical decision of this treatment as well as in the elucidation of its effect. However, controversial findings are still noted in the literature. Moreover, there are no existing models for efficient prediction of intervertebral disk stresses within annulus fibrosus (AF) and nucleus pulposus (NP) regions. In this present study, a new hybrid rigid-deformable modeling workflow was established to quantify the mechanical stress behaviors within AF and NP regions of the L1–2, L2–3, and L4–5 disks after interbody fusion at L3–4 level. The changes in spinal loads were compared with results of the intact model without interbody fusion. The fusion outcomes revealed maximal stress changes (10%) in AF region of L1–2 disk and in NP region of L2–3 disk. The minimal stress change (1%) is noted at the NP region of the L1–2 disk. The validation of simulation outcomes of fused and intact lumbar spine models against those of other computational models and in vivo measurements showed good agreements. Thus, this present study may be used as a novel design guideline for a specific implant and surgical scenario of the lumbar spine disorders.

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Dynamic compared to rigid fixation in lumbar spine: a systematic review

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.60.02.013 ◽

2014 ◽

Vol 60 (2) ◽

pp. 151-155 ◽

Cited By ~ 1

Author(s):

Ricardo Vieira Botelho ◽

Rafael Bastianello Junior ◽

Luciana DiniGianini de Albuquerque ◽

Wanderley Marques Bernardo

Keyword(s):

Systematic Review ◽

Lumbar Spine ◽

Randomized Trials ◽

Published Data ◽

Rigid Fixation ◽

Cochrane Central Register ◽

Pedicle Fixation ◽

Central Register ◽

Spine Fixation

Objective: The objective of this review is to reveal the quality of published data and the effect size of DPFs compared to rigid fixation in lumbar spine. Summary of background data: since 2002, several dynamic pedicle fixation (DPF) systems have been developed with the aim to stabilize the spine without the undesirable effects of rigid lumbar spine fixation. Nearly ten years later, there are several studies on these dynamic systems. Methods: A systematic review was done in MEDLINE/PubMED, Embase, Cochrane Central Register of Randomized Trials and Google Scholar to assess the quality of published literature and the available studied outcomes in randomized controlled trials of DPF. Results: Only three papers described randomized trials studying DPF. One of them focused on protection of adjacent level disease provided by DPF. Conclusion: It was not possible to reveal any evidence for benefits using DPF compared to rigid fixation in surgery for lumbar spine.

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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.

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