Facet Joint Signal Change on MRI at Levels of Acute/Subacute Lumbar Compression Fractures

Abstract

BACKGROUND AND PURPOSE:The prevalence of facet joint signal change in acute/subacute lumbar vertebral body compression fractures is unknown. We hypothesized that facet joint signal change on MR imaging is more common in facet joints associated with an acute/subacute lumbar compression fracture than those associated with normal vertebral bodies or ones that have a chronic compression fracture.

The posterior ligamentous complex inflammatory syndrome: spread of fluid and inflammation in the retrodural space of Okada

“…10,11,20 In the authors' experience, low-grade perifacet signal change is common and inconsistently associated with axial low back pain. 12 There is uncontrolled case series data describing pain reduction with interspinous ligament steroid injections targeting interspinous T2 hyperintensity, but interspinous signal change also remains an unproven marker of pain. 21 Pars interarticularis defects are frequently present, and are a potential source of axial low back pain.…”

“…Preliminary data support the hypothesis that peri-facet signal change is more common in the setting of increased biomechanical stress such as anterolisthesis. 11,12 In the setting of PLCIS, anterolisthesis may be present due to bilateral pars interarticularis defects or degenerative spondylolisthesis. Pars interarticularis defects could increase the likelihood of fluid and inflammation within and surrounding a facet joint and also facilitate communication with the retrodural space.…”

Review of the Imaging Features of Benign Osteoporotic and Malignant Vertebral Compression Fractures

“…21 Possible reasons include inflammation related to biomechanical stress and/or direct injury. 22 Moreover, malignant VCFs may have preserved marrow signal within 1 or both pedicles (for example, preserved signal on the right in Fig 2) because the presence of abnormal signal is dependent on tumor infiltration.…”

Comparison of facet joint activity on 99mTc-MDP SPECT/CT with facet joint signal change on MRI with fat suppression

“…Facet joint signal change on fat-suppressed images has been shown to increase prevalence at sites of biomechanical stress such as scoliosis, anterolisthesis, or vertebral body compression fracture (9,11), and prevalence could vary by level (11). Since the agreement between imaging studies compared a given facet joint only to itself rather than to other facet joints under different degrees of stress, these potential causes of biomechanical stress were not assessed.…”

“…To facilitate comparison with 99m Tc-MDP SPECT/CT ratings, each facet joint was first rated as either positive for signal change on fat-suppressed MRI or normal. Each positive facet joint was assigned a grade of 1 to 4 using a grading scale described previously by Czervionke and Fenton (8) and used in other prior investigation (9). This grading scale can be applied to either T2-weighted images with fat suppression or T1-weighted images with fat suppression and intravenous gadolinium administration.…”