Abstract
Purpose
This study aimed to evaluate facet joint parameters and osteoarthritis grades, and segmental angular and translational motions among different grades of L5/S1 intervertebral disc (IVD) degeneration.
Methods
This retrospective study analysed kinematic magnetic resonance imaging (kMRI) images of the lumbar spine of 214 patients with low back pain. Degenerations of the L5/S1 IVDs and facet joints osteoarthritis were assessed using the Pfirrmann and Pathria grading scales, respectively. Facet joint parameters included facet joint angle and facet joint space width. Angular and translation segmental motions were measured using MRI Analyzer software.
Results
The mean age of the studied patients was 44.1 ± 13.9 years. Patients with L5/S1 disc degeneration were associated with higher odds of facet joint osteoarthritis (odds ratio = 2.28, 95% confidence interval = 1.23–4.23, P = 0.008). There was a positive correlation between L5/S1 disc degeneration grade and the facet joint grade (r = 0.365, P > 0.001). Grade IV facet joint osteoarthritis did not appear in grades I or II disc degeneration (P > 0.001). The average facet joint width decreased significantly with increasing Pfirrmann grading (P = 0.017). The difference in facet joint angle between groups was not statistically significant (P = 0.532). The differences in the angular and translational motions were not statistically significant (P = 0.530, and 0.510, respectively).
Conclusion
A positive correlation exists between L5/S1 disc degeneration and facet joint osteoarthritis grades. The facet joint space width decreases significantly with increasing grade of disc degeneration.
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References
Iorio JA, Jakoi AM, Singla A (2016) Biomechanics of degenerative spinal disorders. Asian Spine J 10(2):377–384. https://doi.org/10.4184/asj.2016.10.2.377
Kundakci YE, Unver Dogan N, Guler I, Uysal II, Fazliogullari Z, Karabulut AK (2018) Evaluation of the facet joints with magnetic resonance images in the patients with disc degeneration and spondylolisthesis. Surg Radiol Anat 40(9):1063–1075. https://doi.org/10.1007/s00276-018-2052-y
Szpalski M, Gunzburg R (2003) Lumbar spinal stenosis in the elderly: an overview. Eur Spine J 12(Suppl 2):S170–175. https://doi.org/10.1007/s00586-003-0612-1
Yong-Hing K, Kirkaldy-Willis WH (1983) The pathophysiology of degenerative disease of the lumbar spine. Orthop Clin North Am 14(3):491–504
Kushchayev SV, Glushko T, Jarraya M, Schuleri KH, Preul MC, Brooks ML, Teytelboym OM (2018) ABCs of the degenerative spine. Insights Imaging 9(2):253–274. https://doi.org/10.1007/s13244-017-0584-z
Lotz JC, Fields AJ, Liebenberg EC (2013) The role of the vertebral end plate in low back pain. Global Spine J 3(3):153–164. https://doi.org/10.1055/s-0033-1347298
Clarencon F, Law-Ye B, Bienvenot P, Cormier E, Chiras J (2016) The degenerative spine. Magn Reson Imaging Clin N Am 24(3):495–513. https://doi.org/10.1016/j.mric.2016.04.008
Amundsen T, Weber H, Nordal HJ, Magnaes B, Abdelnoor M, Lilleas F (2000) Lumbar spinal stenosis: conservative or surgical management?: A prospective 10-year study. Spine 25(11):1424–1435. https://doi.org/10.1097/00007632-200006010-00016
Sabnis AB, Chamoli U, Diwan AD (2018) Is L5–S1 motion segment different from the rest? A radiographic kinematic assessment of 72 patients with chronic low back pain. Eur Spine J 27(5):1127–1135. https://doi.org/10.1007/s00586-017-5400-4
Michelini G, Corridore A, Torlone S, Bruno F, Marsecano C, Capasso R, Caranci F, Barile A, Masciocchi C, Splendiani A (2018) Dynamic MRI in the evaluation of the spine: state of the art. Acta Biomed 89 (1-S):89–101. 10.23750/abm.v89i1-S.7012
Rucco V, Basadonna PT, Gasparini D (1996) Anatomy of the iliolumbar ligament: a review of its anatomy and a magnetic resonance study. Am J Phys Med Rehabil 75(6):451–455
Snijders CJ, Hermans PF, Niesing R, Spoor CW, Stoeckart R (2004) The influence of slouching and lumbar support on iliolumbar ligaments, intervertebral discs and sacroiliac joints. Clin Biomech (Bristol, Avon) 19(4):323–329. https://doi.org/10.1016/j.clinbiomech.2004.01.006
Grobler LJ, Robertson PA, Novotny JE, Pope MH (1993) Etiology of spondylolisthesis Assessment of the role played by lumbar facet joint morphology. Spine 18(1):80–91
Masharawi Y, Rothschild B, Dar G, Peleg S, Robinson D, Been E, Hershkovitz I (2004) Facet orientation in the thoracolumbar spine: three-dimensional anatomic and biomechanical analysis. Spine 29(16):1755–1763. https://doi.org/10.1097/01.brs.0000134575.04084.ef
Pathria M, Sartoris DJ, Resnick D (1987) Osteoarthritis of the facet joints: accuracy of oblique radiographic assessment. Radiology 164(1):227–230. https://doi.org/10.1148/radiology.164.1.3588910
Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26(17):1873–1878. https://doi.org/10.1097/00007632-200109010-00011
Zheng CJ, Chen J (2015) Disc degeneration implies low back pain. Theor Biol Med Model 12:24. https://doi.org/10.1186/s12976-015-0020-3
Boos N, Weissbach S, Rohrbach H, Weiler C, Spratt KF, Nerlich AG (2002) Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo Award in basic science. Spine 27(23):2631–2644. https://doi.org/10.1097/00007632-200212010-00002
Fujiwara A, Tamai K, Yamato M, An HS, Yoshida H, Saotome K, Kurihashi A (1999) The relationship between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI study. Eur Spine J 8(5):396–401. https://doi.org/10.1007/s005860050193
Butler D, Trafimow JH, Andersson GB, McNeill TW, Huckman MS (1990) Discs degenerate before facets. Spine 15(2):111–113. https://doi.org/10.1097/00007632-199002000-00012
Suri P, Miyakoshi A, Hunter DJ, Jarvik JG, Rainville J, Guermazi A, Li L, Katz JN (2011) Does lumbar spinal degeneration begin with the anterior structures? A study of the observed epidemiology in a community-based population. BMC Musculoskelet Disord 12:202. https://doi.org/10.1186/1471-2474-12-202
Murata M, Morio Y, Kuranobu K (1994) Lumbar disc degeneration and segmental instability: a comparison of magnetic resonance images and plain radiographs of patients with low back pain. Arch Orthop Trauma Surg 113(6):297–301
Soini J, Antti-Poika I, Tallroth K, Konttinen YT, Honkanen V, Santavirta S (1991) Disc degeneration and angular movement of the lumbar spine: comparative study using plain and flexion-extension radiography and discography. J Spinal Disord 4(2):183–187
Lao L, Daubs MD, Scott TP, Lord EL, Cohen JR, Yin R, Zhong G, Wang JC (2015) Effect of disc degeneration on lumbar segmental mobility analyzed by kinetic magnetic resonance imaging. Spine 40(5):316–322. https://doi.org/10.1097/BRS.0000000000000738
Tan Y, Aghdasi BG, Montgomery SR, Inoue H, Lu C, Wang JC (2012) Kinetic magnetic resonance imaging analysis of lumbar segmental mobility in patients without significant spondylosis. Eur Spine J 21(12):2673–2679. https://doi.org/10.1007/s00586-012-2387-8
Morishita Y, Hymanson H, Miyazaki M, Zhang HH, He W, Wu G, Kong MH, Wang JC (2008) Kinematic evaluation of the spine: a kinetic magnetic resonance imaging study. J Orthop Surg (Hong Kong) 16(3):348–350. https://doi.org/10.1177/230949900801600316
Cakir B, Richter M, Kafer W, Wieser M, Puhl W, Schmidt R (2006) Evaluation of lumbar spine motion with dynamic X-ray–a reliability analysis. Spine 31(11):1258–1264. https://doi.org/10.1097/01.brs.0000217763.80593.50
Kalichman L, Hunter DJ (2008) The genetics of intervertebral disc degeneration. Familial predisposition and heritability estimation. Joint Bone Spine 75(4):383–387. https://doi.org/10.1016/j.jbspin.2007.11.003
Elfering A, Semmer N, Birkhofer D, Zanetti M, Hodler J, Boos N (2002) Risk factors for lumbar disc degeneration: a 5-year prospective MRI study in asymptomatic individuals. Spine 27(2):125–134. https://doi.org/10.1097/00007632-200201150-00002
Battie MC, Videman T, Gill K, Moneta GB, Nyman R, Kaprio J, Koskenvuo M (1991) 1991 Volvo Award in clinical sciences. Smoking and lumbar intervertebral disc degeneration: an MRI study of identical twins. Spine 16(9):1015–1021
Samartzis D, Karppinen J, Chan D, Luk KD, Cheung KM (2012) The association of lumbar intervertebral disc degeneration on magnetic resonance imaging with body mass index in overweight and obese adults: a population-based study. Arthritis Rheum 64(5):1488–1496. https://doi.org/10.1002/art.33462
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JCW- Royalties – Biomet, Seaspine, Amedica, DePuy Synthes; Investments/Options – Bone Biologics, Pearldiver, Electrocore, Surgitech; Board of Directors - North American Spine Society, AO Foundation (20,000 honorariums for board position, plus travel for board meetings), Cervical Spine Research Society; Editorial Boards - Spine, The Spine Journal, Clinical Spine Surgery, Global Spine Journal; Fellowship Funding (paid directly to institution): AO Foundation; ZB- consultancy: Cerapedics, The Scripps Research Institute, Xenco Medical (past), AO Spine (past); Research Support: SeaSpine (past, paid to the institution), Next Science (paid directly to institution), Motion Metrix (paid directly to institution); North American Spine Society: committee member; Lumbar Spine Society: Co-chair Research committee, AOSpine Knowledge Forum Degenerative: Associate member; AOSNA Research committee- committee member.
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Mesregah, M.K., Lee, H., Roberts, S. et al. Evaluation of facet joints and segmental motion in patients with different grades of L5/S1 intervertebral disc degeneration: a kinematic MRI study. Eur Spine J 29, 2609–2618 (2020). https://doi.org/10.1007/s00586-020-06482-9
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DOI: https://doi.org/10.1007/s00586-020-06482-9