A comparative study of the anatomical, radiological and therapeutic features of the lumbar facet joints

Tournade, A.; Patay, Zoltán; Krůpa, Petr; Tajahmady, T.; Million, Stephanie K.; Braun, M

doi:10.1007/bf00588176

Cited by 18 publications

(3 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…34 Orientation at L4-L5 begins to rotate laterally from the sagittal plane towards the frontal plane and the orientation witnessed at L5-S1 is more obliquely oriented at approximately 15 Њ to 60 Њ from the frontal plane. [34][35][36][37][38][39] This configuration, in concert with the outer anulus of the disc, constrains axial rotation in the upper lumbar levels. 34,40 Approximately 80% of the normal compressive load is born on the IV disc in the adolescent, while the ZAJ only carry approximately 20% of that same load.…”

Section: The Zygapophyseal Jointmentioning

confidence: 99%

“…Lumbar ZAJ are vertically oriented in the parasagittal plane at the L1‐L2 and L2‐L3 levels 34 . Orientation at L4‐L5 begins to rotate laterally from the sagittal plane towards the frontal plane and the orientation witnessed at L5‐S1 is more obliquely oriented at approximately 15° to 60° from the frontal plane 34–39 . This configuration, in concert with the outer anulus of the disc, constrains axial rotation in the upper lumbar levels 34,40 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pain Generators of the Lumbar Spine

Sizer

Phelps²,

Matthijs³

2001

Pain Practice

View full text Add to dashboard Cite

Different anatomical structures and pathophysiological functions can be responsible for lumbar pain, each producing a distinctive clinical profile. Pain can arise from the intervertebral disc, either acutely as a primary disc related disorder, or as result of the degradation associated with chronic internal disc disruption. In either case, greatest pain provocation will be associated with movements and functions in the sagittal plane. Lumbar pain can also arise from afflictions within the zygapophyseal joint mechanism, as result of synovitis or chondropathy. Either of these conditions will produce the greatest pain provocation during three-dimensional movements, due to maximal stress to either the synovium or joint cartilage. Finally, patients can experience different symptoms associated with irritation to the dural sleeve, dorsal root ganglion, or chemically irritated lumbar nerve root. Differential diagnosis of these conditions requires a thorough examination and provides information that can assist the clinician in selecting appropriate management strategies.

show abstract

Section: The Zygapophyseal Jointmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pain Generators of the Lumbar Spine

Sizer

Phelps²,

Matthijs³

2001

Pain Practice

View full text Add to dashboard Cite

show abstract

“…34 This is in agreement with previous studies, wherein investigators who performed radiographic studies of Z joints emphasized the need for multiple views of the assessed region. 21,26,29,33,35 …”

Section: Introductionmentioning

confidence: 99%

Grading Osteoarthritic Changes of the Zygapophyseal Joints from Radiographs: A Reliability Study

Little

Grieve

Cramer

et al. 2015

Journal of Manipulative and Physiological Therapeutics

View full text Add to dashboard Cite

Objective-This study tested the reliability of a 5-point ordinal scale used to grade the severity of degenerative changes of zygapophyseal (Z) joints on standard radiographs. CORRESPONDING AUTHOR CONTACT INFORMATION: Gregory D. Cramer, DC, PhD, gcramer@nuhs.edu or gregorycramer@sbcglobal.net, NUHS, 200 E. Roosevelt Rd., Lombard, IL 60148,. CONFLICTS OF INTERESTNo conflict of interest were reported. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptMethods-Modifications were made to Kellgren's grading system to improve agreement for grading the severity of osteoarthritic changes in lumbar Z joints. These included adding 1 grade of no degeneration, multiple radiographic views, and structured examiner training. Thirty packets of radiographic files were obtained, which included representation of all 5 grades including no degeneration (0) and Kellgren's 4-point (1 to 4) joint degeneration classification criteria. Radiographs were digitized to create a radiographic atlas that was given to examiners for individual study and blinded evaluation sessions. Intra-rater and inter-rater agreement was determined by weighted kappa (κ w ) from the examination of 79 Z joints (25 packets).Results-Using the modified scale and following training, examiners demonstrated a moderate to substantial level of inter-rater agreement (κ w = 0.57, 0.60, and 0.68). Intra-rater agreement was moderate (κ w = 0.42 and 0.54).Conclusions-The modified Kellgren 5-point grading system provides acceptable intra-and inter-rater reliability when examiners are adequately trained. This grading system may be a useful method for future investigations assessing radiographic osteoarthritis of the Z joints. v

show abstract