The Relationship Between Osteoarthritis of the Lumbar Facet Joints and Lumbosacropelvic Morphology

Şahin, Mehmet Şükrü; Ergun, Adviye; Akin, Aslan

doi:10.1097/brs.0000000000001070

Cited by 20 publications

(11 citation statements)

References 26 publications

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“…Facet joint degeneration can act as a surrogate marker for a number of structural changes of the spine, almost all of which might make the administration of neuraxial block difficult in a given inter-spinous space. Those include: degenerative disc disease [11][12][13], narrowing of intervertebral space, increase in L1-5 lumbar lordosis, pelvic incidence, sacral slope [14], associated bucking and hypertrophy of ligamentum flavum, ligamentum flavum calcification [15] and spinal canal stenosis [16].…”

Section: Discussionmentioning

confidence: 99%

Facet joint degeneration adversely affects ultrasound imaging of the lumbar spine

et al. 2019

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Aim: Ultrasound of neuraxis can be used to identify the best possible inter-spinous space to perform neuraxial block. The aim of this study was to assess the anatomical correlation between neuraxial ultrasound and magnetic resonance imaging (MRI). Material and method: Twenty-one patients who underwent MRI of the lumbar spine had ultrasound of lumbar neuraxis performed by an experienced operator. Each lumbar interspinous space was graded on ultrasound as good [posterior complex (ligamentum flavum and duramater) and anterior complex (posterior longitudinal ligament) visible], intermediate (either anterior complex or posterior complex visible) or poor (both anterior complex and posterior complex not visible) in both the transverse median (TM) and paramedian sagittal oblique (PSO) plane. Pre-determined MRI parameters were measured by a radiologist blinded to sonographic findings at each inter-spinal level. Results: Seventy-eight lumbar interspinous spaces were evaluated. There was a significant association (p<0.004) between the facet joint degeneration on MRI and the poor ultrasound view in the transverse median (TM) group. The odds of obtaining a poor view in TM plane was 7 times higher (95% CI 1.7-28.9, p=0.007) in the presence of facet joint degeneration. None of the other variables had a significant association with a poor neuraxial view in the TM plane. Poor views in the parasagittal oblique (PSO) plane did not correlate with any of the variables measured on MRI. Conclusion: Facet joint degeneration is a major contributing factor to poor neuraxial ultrasound views in the TM plane.

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Section: Discussionmentioning

confidence: 99%

Facet joint degeneration adversely affects ultrasound imaging of the lumbar spine

et al. 2019

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Section: Discussionmentioning

confidence: 99%

“…The most reliable ‘normal range’ for lumbar lordosis, using postural radiographs, has been reported as 48–78 degrees [ 21 , 22 , 26 ]. The heterogeneity of methods used to measure lumbar lordosis in the literature has resulted in various ranges of proposed ‘normal’ values [ 21 , 22 ]. This wide range of ‘normal’ values is also partly due to the fact that lumbar lordosis is driven primarily by the variation in the position-independent sagittal alignment of the pelvis (PI) [ 27 , 28 ] which varies widely between individuals.…”

Section: Discussionmentioning

confidence: 99%

Characterisation of the correlation between standing lordosis and degenerative joint disease in the lower lumbar spine in women and men: a radiographic study

Murray

Grande

Mues

et al. 2017

BMC Musculoskelet Disord

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BackgroundDegenerative joint disease (DJD) in the lumbar spine is a common condition that is associated with chronic low back pain. Excessive loading of lumbar joints is a risk factor for DJD. Changes in lumbar lordosis significantly redistribute the forces of weight-bearing on the facet joints and the intervertebral discs. However, the relationship between lumbar lordosis and DJD has not been characterized in men and women.MethodsWe characterised the correlation between standing lumbar lordosis and DJD in standing radiographic images from 301 adult female and male chiropractic patients. DJD was rated using the Kellgren-Lawrence scale, and lordosis was measured using the Cobb angle. Linear and curvilinear correlations were investigated while controlling for age and sex.ResultsWe found a highly significant curvilinear correlation between lordosis and DJD of the lower lumbar spine in both sexes, but especially in women, irrespective of the effects of age. We found the effect size of lordosis on lower lumbar DJD to be between 17.4 and 18.1% in women and 12.9% in older men. In addition, lordosis of 65 (95% CI 55.3–77.7) and 68 (98% CI 58.7–73.3) degrees were associated with minimal DJD in the lower lumbar spine of women and men respectively, and were therefore considered ‘optimal’. This optimal lordotic angle was 73 (95% CI 58.8–87.2) degrees in older men.ConclusionsBoth hypo- and hyper-lordosis correlate with DJD in the lumbar spine, particularly in women and in older men. These findings may well be of relevance to spinal pain management and spinal rehabilitation.

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“…This result is in line with some papers in recent literature. Sahin et al 15 analyzed the medialization and tropism of lumbar vertebrae articular surfaces, pointing out that this event occurs previously and worsen fastly with higher PI values; however medialization and tropism can be observed along ageing. From 2,5 to 3% of the loading forces are usually distributed on the vertebrae posterior arch, they weigh on directly on articular apophysis, this percentages vary substantially accordingly to variations of spino-pelvic parameters.…”

Section: Discussionmentioning

confidence: 99%

Finite element analysis of sagittal balance in different morphotype: Forces and resulting strain in pelvis and spine

Filardi

Portaro

Cacciola

et al. 2017

Journal of Orthopaedics

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In humans, vertical posture acquisition caused several changes in bones and muscles which can be assumed as verticalization. Pelvis, femur, and vertebral column gain an extension position which decreases muscular work by paravertebral muscles in the latter. It's widely known that six different morphological categories exist; each category differs from the others by pelvic parameters and vertebral column curvatures. Both values depend on the Pelvic Incidence, calculated as the angle between the axes passing through the rotation centre of the two femur heads and the vertical axis passing through the superior plate of the sacrum. The aim of this study is to evaluate the distribution of stress and the resulting strain along the axial skeleton using finite element analysis. The use of this computational method allows performing different analyses investigating how different bony geometries and skeletal structures can behavior under specific loading conditions. A computerized tomography (CT) of artificial bones, carried on at 1.5 mm of distance along sagittal, coronal and axial planes with the knee at 0° flexion (accuracy 0.5 mm), was used to obtain geometrical data of the model developed. Lines were imported into a commercial code (Hypermesh by Altair) in order to interpolate main surfaces and create the solid version of the model. In particular six different models were created according Roussoly's classification, by arranging geometrical position of the skeletal components. Loading conditions were obtained by applying muscular forces components to T1 till to L5, according to a reference model (Daniel M. 2011), and a fixed constrain was imposed on the lower part of the femurs. Materials were assumed as elastic with an Elastic modulus of 15 GPa, a Shear Modulus of 7 GPa for bony parts, and an Elastic modulus of 6 MPa, a Shear Modulus of 3 MPa for cartilaginous parts. Six different simulations have been carried out in order to evaluate the mechanical behavior of the human vertebral column arranged according to the Russoly's classification; results confirm higher solicitations obtained varying configurations from case I to case VI. In particular way, first three cases seem to supply the different loading configurations spreading stresses in almost all the bony parts of the column, while the remaining others three cases produce an higher concentration of stress around the lower part of spine (L3, L4, L5). Results confirm a good agreement with those present in literature (Winkle et al., 1999), an equivalent Von Mises average stress was of 0,55 MPa was found on the intervertebral disks with the higher values reached on the lower part of the column. A comparison of results obtained for Case I with literature (Galbusera et al., and El Rich et al., 2004), shows a good agreement in terms of normal compressive force, while more evident differences with Galbusera's results can be found for shear force and sagittal moment. The results underline a relationship between PI increase, and accordingly of PT and LL, and the distribution...

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The Relationship Between Osteoarthritis of the Lumbar Facet Joints and Lumbosacropelvic Morphology

Abstract: 4.

Cited by 20 publications

References 26 publications

Facet joint degeneration adversely affects ultrasound imaging of the lumbar spine

Facet joint degeneration adversely affects ultrasound imaging of the lumbar spine

Characterisation of the correlation between standing lordosis and degenerative joint disease in the lower lumbar spine in women and men: a radiographic study

Finite element analysis of sagittal balance in different morphotype: Forces and resulting strain in pelvis and spine

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