Objective: To correlate facet tropism with the side and location of the intervertebral disc in which the lumbar disc herniation occurred. Methods: A retrospective descriptive study that evaluated Magnetic Resonance Imaging of 255 patients with lumbar disc herniation undergoing surgical treatment with the Spine Group of the Hospital Ortopédico de Passo Fundo between 2002 and 2014. The total patient number was stratified according to the side affected by the herniated disc (right or left), location of the hernia in the intervertebral disc (central, centrolateral, foraminal and extraforaminal) and demographic data, such as age, gender etc. The degree of facet joint tropism was measured by the Karakan method and classified as mild (difference less than 7º); moderate (between 7º and 15º) and severe (difference greater than 15º). Results: A statistical significant relationship (p= 0.023) was observed between the facet joint tropism and the side where the lumbar disc herniation occurred. No correlation was found between facet joint tropism and location of the herniation on the intervertebral disc. Conclusions: The degree of facet tropism presents a statistical significant correlation with the side of the intervertebral disc in which the lumbar disc herniation will develop.

Objective To evaluate facet joint degeneration following surgical treatment in patients with lumbar disc herniation, seeking to correlate it with possible determining factors. Methods Cross-sectional observational study, which analyzed medical records, radiographs and magnetic resonance images of 287 patients with lumbar disc herniation treated surgically at the Spine Surgery Service of the Hospital Ortopédico de Passo Fundo. Information about age and sex was collected. In the imaging exams, the following variables were evaluated: facet joint angulation and its tropism, measured by the Karacan method, sacral slope and lumbar lordosis, measured by the Cobb method, arthrosis of the interfacetary joints, measured by the Weishaupt classification, and intervertebral disc degeneration, measured by the Pfirrmann classification. Results A statistically significant relationship was observed between facet joint degeneration and age (p = 0.002), and also between facet joint degeneration and sacral slope (p = 0.038). No correlation was found between facet joint degeneration and lumbar lordosis (p = 0.934). It was found that the most degenerated facet joints were those that had the greatest facet joint asymmetry (tropism). However, the mean degree of facet tropism did not increase homogeneously with the progression of the joint degeneration score (p = 0.380). Conclusion It was verified that there are, in fact, a multiplicity of factors related to the degree of facet joint degeneration in the low lumbar spine. Additional studies, correlated with the asymmetry of the facet joints, would be important to elucidate better preventive management of this degeneration, aiming to avert secondary low back pain and sciatica with advancing age. Level of evidence II; Retrospective study.

<sec><title>OBJECTIVE:</title><p> To evaluate the correlation between kyphosis due to burst fractures of thoracic and lumbar spine and clinical outcome in patients undergoing conservative or surgical treatment.</p></sec><sec><title>METHODS:</title><p> A retrospective, cross-sectional study was conducted with 29 patients with thoracolumbar burst fractures treated by the Spine Group in a trauma reference hospital between the years 2002 and 2011. Patients were followed-up as outpatients for a minimum of 24 months. All cases were clinically evaluated by Oswestry and SF-36 quality of life questionnaires and the visual analogue scale (VAS) of pain. They were also evaluated by X-ray examinations and CT scans of the lumbosacral spine at the time of hospitalization and subsequently as outpatients by Cobb method for measuring the degree of kyphosis.</p></sec><sec><title>RESULTS:</title><p> There was no statistically significant correlation between the degree of initial kyphosis and clinical outcome measured by VAS and by most of the SF-36 domains in both patients treated conservatively and the surgically treated. The Oswestry questionnaire showed benefits for patients who received conservative treatment (p=0.047) compared to those surgically treated (p=0.335). The analysis of difference between initial and final kyphosis and final kyphosis alone in relation to clinical outcome showed no statistical correlation in any of the scores used.</p></sec><sec><title>CONCLUSION:</title><p> The clinical outcome of treatment of the thoracic and lumbar burst fractures was not influenced by a greater or lesser degree of initial or residual kyphosis, regardless of the type of treatment.</p></sec>