Influence of Facet Tropism on the Location of Lumbar Disc Herniation

Tisot, Rodrigo Arnold; Vieira, Juliano Da Silveira; Collares, Diego da Silva; Stumm, Leonardo Domingues; Fontana, M.; Pasini, A.; Coronel, Eduardo; Scharnovski, Eduardo; Agostini, Maiara; Borin, Mateus; Kasper, Victor; Sanchez, V. Pereira; Iserhard, Walter

doi:10.1590/s1808-185120181701179264

Cited by 4 publications

(6 citation statements)

References 28 publications

(22 reference statements)

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“…However, most other authors disagree with this statement. Noren et al 15 and other authors, [16][17][18] concluded that tropism of the facet joint is an important risk factor for the development of disc degeneration, in agreement with Costa et al, 4 who showed that the greater the degree of tropism, the greater the degree of disc degeneration. The correlation was also found in the present study but only at the L4-L5 level, perhaps because of the small sample size of the other levels.…”

Section: Discussionsupporting

confidence: 61%

“…13 A previous study identified a statistically significant relationship between tropism and the side where the lumbar disc herniation occurs. 16 The objective of the present study was to evaluate degenerative lumbar stenosis in symptomatic patients who underwent surgery with follow-up at the Hospital Ortopédico de Passo Fundoand its correlation with probable determining factors, such as facet tropism on the side operated, disc degeneration, and facet degeneration.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Symptomatic Degenerative Lumbar Stenosis With Probable Determining Factors

et al. 2022

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Objective: To evaluate degenerative lumbar stenosis in symptomatic patients submitted to surgeryand the correlation between probable determining factors. Methods: A retrospective descriptive study in which themagnetic resonance images of 73 patients with degenerative stenosis,who underwent surgeries involving 141 levels performed by a single surgeon at the Hospital Ortopédico de Passo Fundo from 2015 to 2018, were evaluated. The patients were stratified by the degree of facet tropism, facet arthrosis, disc degeneration, and operated side, as well as by epidemiological data such as age, sex, etc. Tropism was measured using the Karacan method and evaluated numerically and categorically. Disc degeneration was classified by Pfirrmann and facet arthrosis by Weishaupt. To analyze and obtain the results, the Chi-square test and ANOVA were used with the SPSS statistical program, version 18.0. Results: Statistical significance was found in the relationship between facet tropism and disc degeneration (p=0.026) at the L4-L5 level. No correlation was found between tropism and facet arthrosis (p=0.161) or tropism and the operated side (p=0.573). Conclusion: The degree of tropism directly influences disc degeneration and greater asymmetries are related to more severe degenerations. Although tropism has not shown a statistically significant correlation with the operated side (p=0.573), it is believed that further studies should be carried out on this correlation. Level of evidence II; Retrospective study.

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Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Evaluation of Symptomatic Degenerative Lumbar Stenosis With Probable Determining Factors

et al. 2022

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“…18 Tisot et al too observed 47.1% of patients with LDH in their study to have facet tropism at L5-S1 level. 19 This variation could possibly be attributed to anthropomorphic differences of the population studied in each study.…”

Section: Discussionmentioning

confidence: 96%

Association of facet orientation and tropism with lumbar disc herniation

Deepak

Shetty²,

Reddy

2020

Int J Res Orthop

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Background: Intervertebral disc herniation is a degenerative lumbar disease and a common pathology of skeletal system. Currently, most experts assume that facet tropism may affect lumbar degenerative diseases. Considering the previous inconsistent findings on the relationship of facet tropism, the present study was aimed to find the association between facet tropism and lumbar disc herniation.Methods: Patients with low back pain attending the OPD of orthopaedics department, with signs and symptoms of disc herniation were sent for magnetic resonance imaging (MRI). 72 patients with single level disc herniation were included in the study. Facet angles were measured using MRI of 1.5 T using the method described by Karacan et al. Facet tropism was defined as difference of 100 or more in facet joint angles between right and left sides.Results: 45 of the 72 cases (50%) who presented with lumbar disc herniation (LDH) had tropism while none (0%) at the control level did. This association was not statistically significant (p=0.983). Significant association was found between the side of disc herniation and the distribution of the more coronal or sagittal facing facet (p=0.024).Conclusions: Despite the presence of tropism only in the intervertebral segments affected with LDH in our study, the association between tropism and LDH was not statistically significant.

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“…18,19 The importance of angulation and facet asymmetry, confirmed by facet joint tropism, in relation to pathologies of the lumbar spine, has been investigated by several authors. 8,10,[20][21][22] A statistically significant relationship between the side of the tropism and the side where the lumbar disc herniation occurs, as described by Tisot et al, 8 was apparent. The association between the degree of facet joint angulation and the appearance of degenerative spondylolisthesis, as described by Samartzis 23 and Chotiyarnwong et al, 22 was also found to be statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…7 It should be noted that there is a natural asymmetry between the orientation of the facet joints, called facet joint tropism. 8 Sacral slope and lumbar lordosis are also factors that vary from individual to individual and cause biomechanical changes in the load axis of the lumbar spine. 9 Biomechanical changes below the lumbosacral spine can accelerate the aging of that region and in many individuals early degenerative changes cause chronic low back pain, often incapacitating and difficult to control.…”

Section: Introductionmentioning

confidence: 99%

Facet Joint Degeneration in Patients With Lumbar Disc Herniation and Probable Determining Factors

Tisot

Vieira²,

Collares

et al. 2020

Coluna/Columna

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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.

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Influence of Facet Tropism on the Location of Lumbar Disc Herniation

Cited by 4 publications

References 28 publications

Evaluation of Symptomatic Degenerative Lumbar Stenosis With Probable Determining Factors

Evaluation of Symptomatic Degenerative Lumbar Stenosis With Probable Determining Factors

Association of facet orientation and tropism with lumbar disc herniation

Facet Joint Degeneration in Patients With Lumbar Disc Herniation and Probable Determining Factors

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