Abstract:Objective To explore the cause-effect relationship between facet joint orientations and lumbar degenerative spondylolisthesis.Methods 120 patients with Lumbar Degenerative Spondylolisthesis at L4~5 who were hospitalized in Nanfang Hospital from 2013 to 2015 were included in this study.120 patients with Isthemic Spondylolisthesis at L4~5who were hospitalized in Nanfang Hospital from 2013 to 2015 were included in this study.The control group was consisted of 120 spinal disease-free people who came for annual physical examination in Nanfang hospital.The orientations of the lumbar facet joints were analyzed based on CT tomography images.At the segments of L2~3,L3~4,L4~5and L5 S1,facet joint angulations were measured and the correlation of angulation at L3~4,L 4~5 were analyzed.Results There was no significant difference between Lumbar Isthemic Spondylolisthesis (LIS group) and the control group (LS-free group)in facet joints (P>0.05).There was significant difference between lumbardegenerative spondylolisthesis (LDS group) and the control group (LS-free group)in facet joints (P<0.01).There was no significant difference between different degree degenerative lumbar spondylolisthesis in facet joint angle at L2~3,L3~4and L5 S1.L3~4and L4~5(P>0.05).There was a linear correlation between L3~4 and L4~5facet joint angle(R=0.575).Conclusion Spondylolisthesis had no effect on the facet joint angle at adjacent segment,and the angle of facet joint at different segments was linearly correlated.The angle of facet joint at different segments in LDS groupwere less than LS-free group,and the joint structure other than bony elements seemed to be the early pathological change of facet joints.The bony structure change of facet joints that based on bone remolding adapted to mechanical burden was secondary to ongoing slippage.
[1]Herkowitz HN.Spine update.Degenerative lumbar spondylolisthesis[J].Spine (Phila Pa 1976),1995,20(9):1084-1090.
[2]Rosenberg NJ.Degenerative spondylolisthesis.Predisposing factors[J].J Bone Joint Surg(Am),1975,57(4):467-474.
[3]Adams MA,Hutton WC.The effect of posture on the role of the apophysial joints in resisting intervertebral compressive forces[J].J Bone Joint Surg(Br),1980,62(3):358-362.
[4]Sanderson PL,Fraser RD.The influence of pregnancy on the development of degenerative spondylolisthesis[J].J Bone Joint Surg(Br),1996,78(6):951-954.
[5]Matsunaga S,Sakou T,Morizono Y,et al.Natural history of degenerative spondylolisthesis.Pathogenesis and natural course of the slippage[J].Spine(Phila Pa 1976),1990,15(11):1204-1210.
[6]Bird HA,Eastmond CJ,Hudson A,et al.Is generalized joint laxity a factor in spondylolisthesis?[J].Scand J Rheumatol,1980,9(4):203-205.
[7]Imada K,Matsui H,Tsuji H.Oophorectomy predisposes to degenerative spondylolisthesis[J].J Bone Joint Surg(Br),1995,77(1):126-130.
[8]Wiltse LL,Newman PH,Macnab I.Classification of spondylolisis and spondylolisthesis[J].Clin Orthop Relat Res,1976(117):23-29.
[9]Nagaosa Y,Kikuchi S,Hasue M,et al.Pathoanatomic mechanisms of degenerative spondylolisthesis.A radiographic study[J].Spine (Phila Pa 1976),1998,23(13):1447-1451.
[10]Grobler LJ,Robertson PA,Novotny JE,et al.Etiology of spondylolisthesis.Assessment of the role played by lumbar facet joint morphology[J].Spine (Phila Pa 1976),1993,18(1):80-91.
[11]Noren R,Trafimow J,Andersson GB,et al.The role of facet joint tropism and facet angle in disc degeneration[J].Spine (Phila Pa 1976),1991,16(5):530-532.
[12]Gao F,Hou D,Zhao B,et al.The pediclefacet angle and tropism in the sagittal plane in degenerative spondylolisthesis:a computed tomography study using multiplanar reformations techniques[J].J Spinal Disord Tech,2012,25(2):18-22.
[13]Devine JG,Schenk-Kisser JM,Skelly AC.Risk factors for degenerative spondylolisthesis:a systematic review[J].Evid Based Spine Care J,2012,3(2):25-34.
[14]Lorenzo RL,Hungerford GD,Blumenthal BI,et al.Congenital kyphosis and subluxation of the thoraco-lumbar spine due to vertebral aplasia[J].Skeletal Radiol,1983,10(4):255-257.
[15]Yang KH,King AI.Mechanism of facet load transmission as a hypothesis for low-back pain[J].Spine (Phila Pa 1976),1984,9(6):557-565.
[16]Sato K,Wakamatsu E,Yoshizumi A,et al.The configuration of the laminas and facet joints in degenerative spondylolisthesis.A clinicoradiologic study[J].Spine (Phila Pa 1976),1989,14(11):1265-1271.
[17]Kalichman L,Hunter DJ.Diagnosis and conservative management of degenerative lumbar spondylolisthesis[J].Eur Spine J,2008,17(3):327-335.
[18]Samartzis D,Cheung JP,Rajasekaran S,et al.Critical values of facet joint angulation and tropism in the development of lumbar degenerative spondylolisthesis:An international,large-scale multicenter study by the AO spine asia pacific research collaboration consortium[J].Global Spine J,2016,6(5):414-421.
[19]Wang J,Yang X.Age-related changes in the orientation of lumbar facet joints[J].Spine (Phila Pa 1976),2009,34(17):E596-E598.
[20]Samartzis D,Cheung JP,Rajasekaran S,et al.Is lumbar facet joint tropism developmental or secondary to degeneration? An international,large-scale multicenter study by the AO Spine Asia Pacific Research Collaboration Consortium[J].Scoliosis Spinal Disord,2016(11):9.
[21]杨贤玉.退变性腰椎滑脱发生的相关因素分析[D].广州:南方医科大学,2009.
[22]杨贤玉,王吉兴.腰椎关节突关节的方向和退变程度对退行性腰椎滑脱的影响[J].中国脊柱脊髓杂志,2009,19(1):52-55.