Relationship of Facet Tropism with Degeneration and Stability of Functional Spinal Unit

다국어 초록 (Multilingual Abstract)

Purpose: The authors investigated the effect of lumbar facet tropism (FT) on intervertebral disc degeneration (DD),
facet joint degeneration (FJD), and segmental translational motion. Materials and Methods: Using kinetic MRI
(KMRI), lumbar FT, which was defined as a difference in symmetry of more than 7O between the orientations of the
facet joints, was investigated in 900 functional spinal units (300 subjects) in flexion, neutral, and extension postures.
Each segment at L3-L4, L4-L5, and L5-S1 was assessed based on the extent of DD (grade I-V) and FJD (grade 1-
4). According to the presence of FT, they were classified into two groups; one with FT and one with facet symmetry.
For each group, demographics, DD, FJD and translational segmental motion were compared. Results: The incidence
of FT was 34.5% at L3-L4, 35.1% at L4-L5, and 35.2% at L5-S1. Age and gender did not show any significant
relationship with FT. Additionally, no correlation was observed between DD and FT. FT, however, wasfound to be
associated with a higher incidence of highly degenerated facet joints at L4-L5 when compared to patients without
FT (p < 0.01). Finally, FT was not observed to have any effects upon translational segmental motion. Conclusion:
No significant correlation was observed between lumbar FT and DD or translational segmental motion. However,
FT was shown to be associated significantly with the presence of high grades of FJD at L4-L5. This suggests that at
active sites of segmental motion, FT may predispose to the development of facet joint degeneration.

참고문헌 (Reference)

1 Noren R, "The role of facet joint tropism and facet angle in disc degeneration" 16 : 530-532, 1991

2 Murtagh FR, "The role and incidence of facet tropism in lumba spine degenerative disc disease" 4 : 86-89, 1991

3 Kunakornsawat S, "The relationship of facet tropism to lumbar disc herniation" 90 : 1337-1341, 2007

4 Vanharanta H, "The relationship of facet tropism to degenerative disc disease" 18 : 1000-1005, 1993

5 Loback D, "The relationship between facet orientation and lumbar disc herniation: The role of torsion in intervertebral disc failure" 9 : 560-, 1985

6 Fujiwara A, "The relationship between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI study" 8 : 396-401, 1999

7 Farfan HF, "The relation of facet orientation to intervertebral disc failure" 10 : 179-185, 1967

8 Lee DY, "The influence of facet tropism on herniation of the lumbar disc in adolescents and adults" 88 : 520-523, 2006

9 Boden SD, "Orientation of the lumbar facet joints: association with degenerative disc disease" 78 : 403-11, 1996

10 Dai LY, "Orientation and tropism of lumbar facet joints in degenerative spondylolisthesis" 25 : 40-42, 2001

11 Pfirrmann CW, "Magnetic resonance classification of lumbar intervertebral disc degeneration" 26 : 1873-1878, 2001

12 Grogan J, "Lumbar facet joint tropism does not accelerate degeneration of the facet joints" 18 : 1325-1329, 1997

13 Cassidy JD, "Lumbar facet joint asymmetry, in Intervertebral disc herniation" 17 : 570-574, 1992

14 Park JB, "Facet tropism: a comparision between far lateral and posterolateral lumbar disc herniations" 26 : 677-679, 2001

15 Masharawi Y, "Facet tropism and interfacet shape in the thoracolumbar vertebrae: characterization and biomechanical interpretation" 30 : E281-E292, 2005

16 Berlemann U, "Facet joint remodeling in degenerative spondylolisthesis: an investigation of joint orientation and tropism" 7 : 376-380, 1998

17 Ishihara H, "Facet joint asymmetry as a radiologic feature of lumbar intervertebral disc herniation in children and adolescents" 22 : 2001-2004, 1997

18 Karacan I, "Facet angles in lumbar disc herniation: their relation to anthropometirc features" 29 : 1132-1136, 2004

19 Cyron BM, "Articular tropism and stability of the lumbar spine" 5 : 168-172, 1980

20 Karacan I, "Alteration of facet joint orientation and asymmetry with time in lumbar disc herniation" 16 : 135-138, 2006