Effect of facet-joint degeneration on the in vivo motion of the lower lumbar spine

Abstract Objective: This research studied the in vivo motion characteristics of the L3-S1 lumbar spine with facet-joint degeneration during functional activities.Methods: Thirteen male and 21 female patients with facet-joint degeneration at the L3-S1 spinal region were included in the study. The L3-S1 lumbar segments of all the patients were divide into 3 groups according to the degree of facet joints degeneration (mild, moderate or severe). The ranges of motion (ROM) of the vertebrae was analyzed using a combination of computed tomography and dual fluoroscopic imaging techniques. During functional postures, the ROMs were compared between the 3 groups at each spinal level (L3-L4, L4-L5, and L5-S1). Results: At L3-L4 level, the primary rotations between the mild and moderate groups during left-right twisting activity were significantly different. At L4-L5 level, the primary rotation of the moderate group was significantly higher than the other groups during flexion-extension. During left-right bending activities a significant difference was observed only between the moderate and severe groups. At L5-S1 level, the rotation of the moderate group was significantly higher than the mild group during left-right bending activity.Conclusions: Degeneration of the facet joint alters the ROMs of the lumbar spine. As the degree of facet-joint degeneration increased, the ROMs of the lumbar vertebra that had initially increased, declined. However, when there was severe facet-joint degeneration, the ROMs of lumbar spine declined to levels comparative to the moderate group. The relationship between the stability of the lumbar vertebra and the degree of facet-joint degeneration requires further study.

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Effect of facet-joint degeneration on the in vivo motion of the lower lumbar spine

10.21203/rs.3.rs-27902/v1 ◽

2020 ◽

Author(s):

Jun Yin ◽

Zhang Liu ◽

Chao Li ◽

Shiwei Luo ◽

Qi Lai ◽

...

Keyword(s):

Lumbar Spine ◽

Facet Joint ◽

Imaging Techniques ◽

Lumbar Vertebra ◽

Joint Degeneration ◽

Lower Lumbar Spine ◽

Significant Difference ◽

Flexion Extension ◽

Facet Joint Degeneration

Abstract Objective This research studied the in vivo motion characteristics of the L3-S1 lumbar spine with facet-joint degeneration during functional activities. Methods Thirteen male and 21 female patients with facet-joint degeneration at the L3-S1 spinal region were included in the study. The L3-S1 lumbar segments of all the patients were divide into 3 groups according to the degree of facet joints degeneration (mild, moderate or severe). The ranges of motion (ROM) of the vertebrae was analyzed using a combination of computed tomography and dual fluoroscopic imaging techniques. During functional postures, the ROMs were compared between the 3 groups at each spinal level (L3-L4, L4-L5, and L5-S1). Results At L3-L4 level, the primary rotations between the mild and moderate groups during left-right twisting activity were significantly different. At L4-L5 level, the primary rotation of the moderate group was significantly higher than the other groups during flexion-extension. During left-right bending activities a significant difference was observed only between the moderate and severe groups. At L5-S1 level, the rotation of the moderate group was significantly higher than the mild group during left-right bending activity. Conclusions Degeneration of the facet joint alters the ROMs of the lumbar spine. As the degree of facet-joint degeneration increased, the ROMs of the lumbar vertebra that had initially increased, declined. However, when there was severe facet-joint degeneration, the ROMs of lumbar spine declined to levels comparative to the moderate group. The relationship between the stability of the lumbar vertebra and the degree of facet-joint degeneration requires further study.

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Effect of facet-joint degeneration on the in vivo motion of the lower lumbar spine

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01826-z ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Jun Yin ◽

Zhang Liu ◽

Chao Li ◽

Shiwei Luo ◽

Qi Lai ◽

...

Keyword(s):

Lumbar Spine ◽

Facet Joint ◽

Joint Degeneration ◽

Lower Lumbar Spine ◽

Facet Joint Degeneration ◽

Lower Lumbar

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Facet joint degeneration adversely affects ultrasound imaging of the lumbar spine

Medical Ultrasonography ◽

10.11152/mu-1699 ◽

2019 ◽

Vol 21 (2) ◽

pp. 131

Author(s):

Karthikeyan Srinivasan ◽

Hong Kuan Kok ◽

Mona Mubarak ◽

William Torregianni ◽

Robert Whitty

Keyword(s):

Lumbar Spine ◽

Ligamentum Flavum ◽

Facet Joint ◽

Posterior Longitudinal Ligament ◽

Joint Degeneration ◽

Neuraxial Block ◽

Interspinous Space ◽

Facet Joint Degeneration ◽

Experienced Operator ◽

Magnetic Resonance Imaging Mri

Aim: Ultrasound of neuraxis can be used to identify the best possible inter-spinous space to perform neuraxial block. The aim of this study was to assess the anatomical correlation between neuraxial ultrasound and magnetic resonance imaging (MRI).Material and method: Twenty-one patients who underwent MRI of the lumbar spine had ultrasound of lumbar neuraxis performed by an experienced operator. Each lumbar interspinous space was graded on ultrasound as good [posteriorcomplex (ligamentum flavum and duramater) and anterior complex (posterior longitudinal ligament) visible], intermediate (either anterior complex or posterior complex visible) or poor (both anterior complex and posterior complex not visible) in both the transverse median (TM) and paramedian sagittal oblique (PSO) plane. Pre-determined MRI parameters were measured by a radiologist blinded to sonographic findings at each inter-spinal level.Results: Seventy-eight lumbar interspinous spaces were evaluated. There was a significant association (p<0.004) between the facet joint degeneration on MRI and the poor ultrasound view in the transverse median (TM) group. The odds of obtaining a poor view in TM plane was 7 times higher (95% CI 1.7-28.9, p=0.007) in the presence of facet joint degeneration. None of the other variables had a significant association with a poor neuraxial view in the TM plane. Poor views in the parasagittal oblique (PSO) plane did not correlate with any of the variables measured on MRI.Conclusion: Facet joint degeneration is a major contributing factor to poor neuraxial ultrasound views in the TM plane.

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A Study of Lumbar Disc Herniation and Facet Joint Asymmetry

International Surgery ◽

10.9738/intsurg-d-16-00119.1 ◽

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 > 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.

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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.

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A Cable-Actuated Robotic Lumbar Spine for Palpatory Training of Medical Students

Volume 2: 34th Annual Mechanisms and Robotics Conference, Parts A and B ◽

10.1115/detc2010-28863 ◽

2010 ◽

Cited By ~ 1

Author(s):

Ernur Karadogan ◽

Robert L. Williams

Keyword(s):

Lumbar Spine ◽

Medical Students ◽

Lumbar Vertebrae ◽

Lumbar Vertebra ◽

Professional Lives ◽

Human Lumbar Spine ◽

Flexion Extension ◽

Hands On ◽

Spine Robot

This paper presents the kinematic and pseudostatic analyses of a fully cable-actuated robotic lumbar spine (RLS) which can mimic in vivo human lumbar spine movements to provide better hands-on training for medical students. The design incorporates five active lumbar vertebrae between the first lumbar vertebra and the sacrum, with dimensions of an average adult human spine. Medical schools can benefit from a tool, system, or method that will help instructors train students and assess their tactile proficiency throughout their education. The robotic lumbar spine has the potential to satisfy these needs in palpatory diagnosis. Medical students will be given the opportunity to examine their own patient that can be programmed with many dysfunctions related to the lumbar spine before they start their professional lives as doctors. The robotic lumbar spine can be used to teach and test medical students in their capacity to be able to recognize normal and abnormal movement patterns of the human lumbar spine under flexion-extension and lateral bending. This project focus is on palpation, but the spine robot could also benefit surgery training/planning and other related biomedical applications.

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Ligamentum flavum thickening at lumbar spine is associated with facet joint degeneration: An MRI study

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-160688 ◽

2016 ◽

Vol 29 (4) ◽

pp. 771-777 ◽

Cited By ~ 2

Author(s):

Ergun Karavelioglu ◽

Emre Kacar ◽

Yucel Gonul ◽

Mehmet Eroglu ◽

Mehmet Gazi Boyaci ◽

...

Keyword(s):

Lumbar Spine ◽

Ligamentum Flavum ◽

Facet Joint ◽

Joint Degeneration ◽

Facet Joint Degeneration ◽

Mri Study

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Correlation between Lumbar Spine Facet Joint Orientation and Intervertebral Disk Degeneration: A Positional MRI Analysis

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0039-1683450 ◽

2019 ◽

Vol 80 (04) ◽

pp. 255-261

Author(s):

Xin Jiang ◽

Dong Chen ◽

Zhongshi Li ◽

Yahao Lou

Keyword(s):

Lumbar Spine ◽

Facet Joint ◽

Intervertebral Disk ◽

Midsagittal Plane ◽

Joint Orientation ◽

Intervertebral Disk Degeneration ◽

Disk Degeneration ◽

Lower Lumbar Spine ◽

Significant Difference ◽

Spinal Segments

Background and Study Aims The contribution of facet joint orientation (FO) to degeneration of the functional units of the lumbar spine remains unclear. The study used positional magnetic resonance imaging (MRI) to evaluate the association between intervertebral disk degeneration and FO at the L3–L4 to L5–S1 spinal segments. Material and Methods This was a retrospective study of 450 outpatients admitted to the Spine Surgery Department of our hospital between January 2013 and January 2015 and with positional lumbar MRI data. Grade of intervertebral disk degeneration, FO relative to the midsagittal plane, vertebral translation (VT), and angular variation (AV) were assessed. Results No effect of baseline characteristics (age, sex, and body mass index) on intervertebral disk degeneration was observed. A significant difference in VT and AV was only present between grades 1 + 2 versus 4 at L5–S1 (both p = 0.005), and in FO only at L5–S1 between grades 1 + 2 versus 4 (p = 0.03) and grades 3 versus 4 (p = 0.04). AV and VT were correlated at all three lumbar segments (r = 0.224–0.309; p ≥ 0.01), with a correlation between FO and AV only at L3–L4 (r = 0.141; p = 0.035). Conclusion Disk degeneration was associated with FO only at L5–S1. AV and VT of spinal segments of the mid to lower lumbar spine did not correlate with FO.

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Magnetic resonance imaging grading of interspinous ligament degeneration of the lumbar spine and its relation to aging, spinal degeneration, and segmental motion

Journal of Neurosurgery Spine ◽

10.3171/2010.4.spine09515 ◽

2010 ◽

Vol 13 (4) ◽

pp. 494-499 ◽

Cited By ~ 14

Author(s):

Gun Keorochana ◽

Cyrus E. Taghavi ◽

Shiau-Tzu Tzeng ◽

Yuichiro Morishita ◽

Jeong Hyun Yoo ◽

...

Keyword(s):

Mr Imaging ◽

Elderly Patients ◽

Facet Joint ◽

Functional Unit ◽

Grading System ◽

Segmental Motion ◽

Joint Degeneration ◽

Significant Difference ◽

Facet Joint Degeneration ◽

Severe Grade

Object Degenerative changes of the interspinous ligaments (ISLs) have generally been ignored in previous studies. Factor-related causes, the effects that these changes have on other structures within the spinal functional unit, and their relation to kinematic changes in the spine are lacking. In this study, the authors evaluated the reliability of a proposed MR imaging grading system of ISL degeneration (ISLD). They also investigated the relationship between ISLD and aging, disc/facet joint degeneration, and lumbar segmental motion. Methods The authors studied 256 lumbar motion segments from L-2 to S-1 in 64 patients (35 men and 29 women) with a mean age of 46.08 years (range 23–85 years). An MR imaging–based grading system for ISLD was developed and ranged from Grade A (mild) to Grade D (severe). The reliability was tested, and the correlation of the grade with the severity of the disc and facet joint degeneration was examined. The segmental motion of each functional unit was measured using flexion/extension MR imaging, and their relationships with ISL grades were identified. Results Grade A was observed in 115 levels (44.9%), Grade B in 105 (41.0%), Grade C in 15 (5.9%), and Grade D in 21 levels (8.2%). The kappa coefficients for intraobserver and interobserver agreements were substantial to excellent (intraobserver [0.871] and interobserver [0.721–0.807]). Grade D was observed primarily in elderly patients. Segmental motion tended to decrease in the most severe grade, with a significant difference in angular mobility. As the severity of ISLD increased, the severity of disc/facet joint degeneration increased (p < 0.001 and p < 0.05, respectively). Conclusions The authors proposed a reliable and reproducible grading system that may be used to investigate spinal kinematics in association with ISLD. The authors' findings illustrated the distribution of ISLD grades. The most severe grade occurred primarily in elderly patients. Mobility decreased in the most severe grade; therefore, the stage of ISLD should be taken into consideration when evaluating spinal stability.

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