Does Lumbar Facet Arthrosis Precede Disc Degeneration?

Eubanks, Jason David; Lee, Michael J.; Cassinelli, Ezequiel H.; Ahn, Nicholas U.

doi:10.1097/blo.0b013e3181583d4e

Cited by 43 publications

(16 citation statements)

References 20 publications

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“…Then, an increase in the rotational and transitional forces leads to the overloading of the facet joints. This, in turn, leads to a progressive degenerative change in the facet joint, with a lag of over two decades following the onset of disc degeneration 6 , 7 , 10 , 11 , 12 , 15 , 23) . Disc degeneration is believed to precede facet joint degeneration, and to be a primary cause of anterolisthesis 6 , 17 , 24) .…”

Section: Discussionmentioning

confidence: 99%

Retrolisthesis as a Compensatory Mechanism in Degenerative Lumbar Spine

Jeon

Kim

2015

J Korean Neurosurg Soc

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ObjectivePosterior vertebral translation as a type of spondylolisthesis, retrolisthesis is observed commonly in patients with degenerative spinal problems. Nevertheless, there is insufficient literature on retrolisthesis compared to anterolisthesis. The purpose of this study is to clarify the clinical features of retrolisthesis, and its developmental mechanism associated with a compensatory role in sagittal imbalance of the lumbar spine.MethodsFrom 2003 to 2012, 230 Korean patients who underwent spinal surgery in our department under the impression of degenerative lumbar spinal disease were enrolled. All participants were divided into four groups : 35 patients with retrolisthesis (group R), 32 patients with simultaneous retrolisthesis and anterolisthesis (group R+A), 76 patients with anterolisthesis (group A), and 87 patients with non-translation (group N). The clinical features and the sagittal parameters related to retrolisthesis were retrospectively analyzed based on the patients' medical records.ResultsThere were different clinical features and developmental mechanisms between retrolisthesis and anterolisthesis. The location of retrolisthesis was affected by the presence of simultaneous anterolisthesis, even though it predominantly manifest in L3. The relative lower pelvic incidence, pelvic tilt, and lumbar lordosis compared to anterolisthesis were related to the generation of retrolisthesis, with the opposite observations of patients with anterolisthesis.ConclusionRetrolisthesis acts as a compensatory mechanism for moving the gravity axis posteriorly for sagittal imbalance in the lumbar spine under low pelvic incidence and insufficient intra-spinal compensation.

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Section: Discussionmentioning

confidence: 99%

Retrolisthesis as a Compensatory Mechanism in Degenerative Lumbar Spine

Jeon

Kim

2015

J Korean Neurosurg Soc

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“…DS is believed to be initially triggered by posterior ligament and facet laxity, which promotes hypermobility. Thereafter, a decrease in proteoglycan and water content within the degenerated disc further alters the kinematics of the motion segment[ 17 , 18 ]. To re-stabilize the motion segment, facet joint hypertrophy occurs, but might result in spinal canal stenosis.…”

Section: Discussionmentioning

confidence: 99%

The effects of anterior vacuum disc on surgical outcomes of degenerative versus spondylolytic spondylolisthesis: at a minimum two-year follow-up

Lin

Liao

Tsai

et al. 2014

BMC Musculoskelet Disord

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BackgroundThe vacuum phenomenon within the intervertebral disc usually represents disc degeneration. There are no reports in the English literature that focus on the effect of an anterior vacuum disc on surgical outcome of same-segment spondylolisthesis.MethodsPatients with degenerative spondylolisthesis (DS) or isthmic spondylolisthesis (IS) who underwent a spinal surgery between January 2005 and December 2006 were reviewed. Patients who met certain criteria, including (1) only mono-segment spondylolisthesis, (2) gas air within the disc space of the spondylolisthesis segment on preoperative radiographs, (3) having received posterior decompression, posterior pedicle screw fixation, and posterolateral fusion, and (4) at least 12 months of follow-up radiographs available to define the posterolateral fusion rate, were enrolled into the study. Four radiographic parameters (disc height, translation, intradiscal angle, segmental angle) were assessed. Two-year postoperative radiographs were used to determine whether the posterolateral segment was fused or not. Clinical outcome and complications during the follow-up period were documented.ResultsIncidence of the disc vacuum phenomenon was significantly higher in the IS group than in the DS group (p < 0.001). The IS group had more listhesis and a narrower disc height on preoperative static radiographs; however, the DS group had a more prominent angle and listhesis change in preoperative dynamic variables. The posterolateral fusion rate was significantly higher in the IS group (p = 0.019). The preoperative Oswestry Disability Index (ODI) score, the final ODI, and the ODI difference were similar between groups. More excellent and good results were seen in the IS group. Besides, better final ODI and results were seen in the bilateral fusion group than in the nonfusion group.ConclusionThe disc vacuum phenomenon is not equal to anterior instability absolutely. Determination of stability or instability in a vacuum disc should be considered by a combination of dynamic radiographs. In the present study, vacuum discs in the DS group showed more instability and a higher posterolateral pseudoarthrosis rate.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-329) contains supplementary material, which is available to authorized users.

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“…[155][156][157][158] While facet arthrosis and IVD degeneration are the most prevalent factors in chronic LBP, the sequential relationship between the 2 processes is not well defined. [159][160][161][162] Both types of degeneration have been shown to restrict spinal motion which could increase the loading in both IVD and facet joint. 163,164 However, further research is needed to clearly identify the relationship between the 2 degenerative processes.…”

Section: Biomechanics Of Healthy and Diseased Discsmentioning

confidence: 99%

Pathomechanism and Biomechanics of Degenerative Disc Disease: Features of Healthy and Degenerated Discs

et al. 2021

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The human intervertebral disc (IVD) is a complex organ composed of fibrous and cartilaginous connective tissues, and it serves as a boundary between 2 adjacent vertebrae. It provides a limited range of motion in the torso as well as stability during axial compression, rotation, and bending. Adult IVDs have poor innate healing potential due to low vascularity and cellularity. Degenerative disc disease (DDD) generally arises from the disruption of the homeostasis maintained by the structures of the IVD, and genetic and environmental factors can accelerate the progression of the disease. Impaired cell metabolism due to pH alteration and poor nutrition may lead to autophagy and disruption of the homeostasis within the IVD and thus plays a key role in DDD etiology. To develop regenerative therapies for degenerated discs, future studies must aim to restore both anatomical and biomechanical properties of the IVDs. The objective of this review is to give a detailed overview about anatomical, radiological, and biomechanical features of the IVDs as well as discuss the structural and functional changes that occur during the degeneration process.

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Does Lumbar Facet Arthrosis Precede Disc Degeneration?

Cited by 43 publications

References 20 publications

Retrolisthesis as a Compensatory Mechanism in Degenerative Lumbar Spine

Retrolisthesis as a Compensatory Mechanism in Degenerative Lumbar Spine

The effects of anterior vacuum disc on surgical outcomes of degenerative versus spondylolytic spondylolisthesis: at a minimum two-year follow-up

Pathomechanism and Biomechanics of Degenerative Disc Disease: Features of Healthy and Degenerated Discs

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