Associations between facet tropism and vertebral rotation in patients with degenerative lumbar disease

Background Vertebral rotation and facet tropism are very common in various lumbar degenerative diseases. Facet tropism means the presence of asymmetric angles on both sides of the facet joints. Studies have shown that facet tropism contributes to lumbar degenerative disease, and also inevitably leads to the asymmetry of movement and the imbalance of force, which may be possible to rotate the vertebral body. The aim of this study was to explore the correlation between lumbar vertebral rotation and facet tropism in patients with lumbar degenerative diseases. Methods A total of 198 patients with lumbar degenerative diseases from 2018 to 2019 were enrolled. Five hundred and seventy vertebral rotation angles and 1140 facet angles were measured. The vertebral bodies are divided into non-rotation group (Group A) and rotation group (Group B) with the vertebral rotation angle of 3° as the boundary. The information including gender, age, BMI (body mass index), bone mineral density, history of smoking, drinking, hypertension, diabetes, diagnosis, segment distribution, and degree of facet degeneration were also counted. Using inter-class correlation coefficients (ICC) to test the reliability of measurement results. Univariate and multivariate logistic regression analysis were used to analyze the relationship between vertebral rotation and facet tropism. Results The consistency of the ICC within the groups of the observers is above 0.8, with good agreement. The results of univariate analysis showed that facet tropism was significantly different between group A and group B (OR (odds ratio) = 3.30, 95% CI = 2.03–5.35, P < 0.0001). Other significant factors were included as adjustment variables into the multivariate regression model. Three models were analyzed separately (Model 1: non-adjusted. Model 2: adjust for age; facet degeneration; Model 3: adjust for age; disease distribution; segment distribution; facet degeneration). The results showed that after adjusting the confounders, the correlation between facet tropism and vertebral rotation did not change (Model 1: OR = 3.30, 95% CI = 2.03–5.35, P < 0.0001; Model 2: adjusted OR = 2.87, 95% CI = 1.66–4.97, P = 0.0002, Model 3: adjusted OR = 2.84, 95% CI = 1.56–5.17, P = 0.0006). Conclusion Current research demonstrates that there is an association between vertebral rotation and facet tropism, suggesting that vertebral rotation may also have a certain degree of correlation with lumbar degenerative diseases.

The Correlation Between Facet Joint Parameters and the Location of Lumbar Disc Herniation in the Young Population

Background: Facet joint parameters have been discussed as substantial factors in the development of LDH. However, the correlation between facet joint parameters and the location of LDH in the corresponding segment is still unclear. The objective of this study was to demonstrate a clearly relationship between facet orientation (FO), facet tropism (FT) and lumbar disc herniation (LDH) in young individuals.Methods: Between June 2017 and December 2019, 529 patients having single-level LDH (L4-5 or L5-S1) between 18 and 35 years old with a less than 2 years clinical history were included. Another 122 age-matched patients with no LDH were enrolled as the control group (N-LDH group). Based on the location of herniation, cases in LDH group were divided into three groups (LDHL, LDHR, and LDHM). We investigated the correlation between facet joint parameters and the location of LDH.Results: The FOA in L4-5 and L5-S1 level were significantly lower while FT were higher in LDH group than N-LDH group respectively. In terms of the correlation between the facet joint parameters and the location of LDH, the level of LDH, the FOL, FOR, and FT were significantly varied among the three groups. There is a significant association between the different location of LDH and different FO of bilateral facet joints in L4-5 while not in L5-S1 level.Conclusion: The facet joint parameters abnormality have an significant association with the development of LDH. Young individuals with higher FT and/or lower FO should be paid more attention to preventing the occurrence of LDH. There was more location of IVD herniated on the ipsilateral location with lower FO of facet joint when FT existed in L4-5 level.

Effect of Facet Tropism on Postoperative Cervical Range of Motion After Single-Level Cervical Disc Arthroplasty

Study Design: Retrospective analysis. Objectives: Cervical disc arthroplasty (CDA) was designed to replace the degenerated disc with the prosthesis to preserve cervical motion. The commonly used artificial discs are designed symmetric, whereas the facet joints were reported to be asymmetric in many people. This study aimed to evaluate the effect of facet tropism on the cervical range of motion (ROM) after single-level CDA using Prestige LP. Methods: A total of 90 patients who underwent single-level CDA using Prestige LP from 2012 to 2017 were retrospectively reviewed. Radiographs were taken at each time point to measure the C2-C7 ROM and the ROM at the surgical segment. The pre-operation CT scans were utilized to reconstruct and calculate the angular direction of facet joints with respect to transverse, coronal, and sagittal reference planes. Facet tropism above 7° was defined as facet joint asymmetry. Results: No significant difference was found in flexion-extension C2-C7 ROM or ROM at the surgical segment between patients with symmetric and asymmetric fact joints regarding the sagittal plane. Patients with coronal asymmetric facet joints had lower flexion-extension ROM at the surgical level. Patients with transverse asymmetric facet joints had both lower flexion-extension C2-C7 ROM and ROM at the surgical level. After CDA surgery, patients obtained good clinical outcomes including increased Japanese Orthopedic Association (JOA) and decreased Neck Disability Index (NDI) as well as Visual Analogue Scale (VAS). Conclusion: The coronal and transverse tropism seemed to be correlated with decreased flexion-extension ROM after CDA using Prestige LP.

Correlation Between Facet Tropism and Lumbar Disc Herniation

Purpose The relationship between facet tropism (FT) and lumbar disc herniation (LDH) is not clear. In the present study, MRI was used to assess the relationship between lumbar facet joint tropism and disc herniation. This paper is the first to assess the relationship between facet joint tropism and LDH from the sagittal view. Methods 122 patients (154 segments) with lumbar disc herniation and 102 normal subjects (306 segments) who visited our hospital from 01-Jan-2020 to 01-Apr-2020 were included in this study. The axial and sagittal angles of facet joints were measured using an MRI scan. The difference of 10° in facet angles between left and right was defined as lumbar facet tropism. The relationship between the two was analyzed. Results In the axial, 95/154 segments with lumbar disc herniation had FT whereas, 48/258 segments had FT in the normal segments(p<0.01). In the sagittal, 61/154 segments with lumbar disc herniation had FT and 48/306 had FT in the control(p<0.01). Conclusion The proportion of FT is better in patients with lumbar disc herniation, and there is a significant correlation between FT and lumbar disc herniation.