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

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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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

10.21203/rs.3.rs-27902/v2 ◽

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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Does Vertebral Body Tethering Cause Disc and Facet Joint Degeneration? A Preliminary MRI Study with Minimum 2-years Follow-up

The Spine Journal ◽

10.1016/j.spinee.2021.05.020 ◽

2021 ◽

Author(s):

Altug Yucekul ◽

Burcu Akpunarli ◽

Atahan Durbas ◽

Tais Zulemyan ◽

Irem Havlucu ◽

...

Keyword(s):

Vertebral Body ◽

Facet Joint ◽

Joint Degeneration ◽

Facet Joint Degeneration ◽

Mri Study

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122. Does vertebral body tethering cause disc and facet joint degeneration? An MRI study with minimum two years of follow-up

The Spine Journal ◽

10.1016/j.spinee.2021.05.148 ◽

2021 ◽

Vol 21 (9) ◽

pp. S60

Author(s):

Altug Yucekul ◽

Burcu Akpunarli ◽

Atahan Durbas ◽

Tais Zulemyan ◽

Irem Havlucu ◽

...

Keyword(s):

Vertebral Body ◽

Facet Joint ◽

Joint Degeneration ◽

Facet Joint Degeneration ◽

Mri Study

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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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When an incidental MRI finding becomes a clinical issue

Wiener klinische Wochenschrift ◽

10.1007/s00508-019-01576-x ◽

2019 ◽

Vol 132 (1-2) ◽

pp. 27-34

Author(s):

Ursula Schwarz-Nemec ◽

Klaus M. Friedrich ◽

Michael A. Arnoldner ◽

Felix K. Schwarz ◽

Michael Weber ◽

...

Keyword(s):

Disc Degeneration ◽

Facet Joint ◽

Low Grade ◽

Obese Patients ◽

Joint Degeneration ◽

Clinical Issue ◽

Hepatic Diseases ◽

Subcutaneous Edema ◽

Facet Joint Degeneration ◽

Magnetic Resonance Imaging Mri

Summary Background On magnetic resonance imaging (MRI), posterior lumbar subcutaneous edema (PLSE) is a frequent incidental, yet unclear finding within the deep subcutaneous perifascial tissue. This study aimed to investigate PLSE in various pathological lumbar conditions. Methods This retrospective study included the MR images of the lumbar spine of 279 patients (age range 18–82 years) without cardiovascular, renal or hepatic diseases, 79 of whom had low-grade disc degeneration, 101 combined endplate and facet joint degeneration, 53 axial spondyloarthritis and 46 infectious spondylodiscitis. There were 232 patients with a body mass index (BMI) <30, and 47 with a BMI ≥30 (obese). For each group, the relationship between PLSE and BMI was analyzed using multiple logistic regression, and between PLSE extension and BMI using ordinal regression. Results A PLSE was found in 11/79 (13.9%) patients with disc degeneration, 37/101 (36.6%) with endplate and facet joint degeneration, 7/53 (13.2%) with spondyloarthritis, and 28/46 (60.9%) with spondylodiscitis. For each group, a statistically significant relationship was demonstrated between PLSE and BMI (P = 0.000–P = 0.031), except for spondylodiscitis (P = 0.054), as well as between PLSE extension and BMI (P = 0.000–P = 0.049). A PLSE was found in 21.1% of nonobese and 72.3% of obese patients (P = 0.000). Conclusion The presence of PLSE seems to be associated with various lumbar conditions, particularly in obese patients. Its perifascial location may suggest a potential fascial origin; however, PLSE should not to be confused with posttraumatic, postsurgical or infectious edema or edema associated with internal diseases.

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