ROLE OF FACET JOINT ORIENTATION AND FACET TROPISM IN NONSPESIFIC LOW BACK PAIN
Background: Low Back Pain is a complaint at least once we experience all through our life. Although low back pain can be caused by several reasons, mostly low back pain due to nonspecific reasons can be encountered. In this study, our main goal is to examine facet tropism types and facet joint orientation in patients with nonspecific low back pain we have grouped according to age and determine if there is a relationship between the low back pain and facet joint morphology.
Patients and methods: We have retrospectively examined magnetic resonance imaging of 135 patients who applied to the neurosurgery clinic with low back pain complaint in the period of 2017-2018 year. For each phenomenon, facet joint angles have been measured at all vertebra levels. Average values of facet joint angles have been taken and facet orientation has been determined. The difference between right and left facet joint angle has been calculated; degree and type of facet tropism have been determined.
Results: It has been observed that facet joint orientation at L1-2 level was more coronalized in age group of 70-80 when compared to age group of 10-20. â€˜No typeâ€™ facet tropism has been observed in majority of the phenomenon and no significant difference has been observed between lumbar levels and age groups.
Conclusion: As a result of our study; it has been concluded that facet joint orientation and facet tropism are not effective in the etiology of nonspecific low back pain. Furthermore, facet tropism is not related to age and maybe it is an inborn characteristic.
Henschke N, Maher CG, Refshauge KM, Herbert RD, Cumming RG, Bleasel J, et al. Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain. Arthritis Rheum. 2009;60(10):3072-80.
Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736-47.
Deyo RA, Rainville J, Kent DL. What can the history and physical examination tell us about low back pain? JAMA. 1992;268(6):760-5.
An HS, Masuda K, Inoue N. Intervertebral disc degeneration: biological and biomechanical factors. J Orthop Sci. 2006;11(5):541-52.
Boden SD, Riew KD, Yamaguchi K, Branch TP, Schellinger D, Wiesel SW. Orientation of the lumbar facet joints: association with degenerative disc disease. J Bone Joint Surg Am. 1996;78(3):403-11.
Varlotta GP, Lefkowitz TR, Schweiter M, Ericco TJ, Spivak J, Bendo JA, et al. Lumbar facet joint: a review of the current knowledge: Part 1: Anatomy, biomechanics,and grading. Skeletal Radiol. 2010;40(1):13-23.
Chadha M, Sharma G, Arora SS, Kochar V. Association of facet tropism with lumbar disc herniation. Eur Spine J. 2013;22(5):1045-52.
Jelec V, Turner R, Franic M, Korusic A, Rotim K. Facet orientation and tropism: Association with accelerated degeneration of stabilizing structures in lower lumbar spine. Acta Clin Croat. 2016;55(1):117-24.
Hirsch C. Etiology and pathogenesis of low back pain. Isr J Med Sci. 1966;2:362-70.
Global Burden of Disease Study 2013 Collaborators. Global,regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries. 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(9995):743-800.
Swain MS, Henschke N, Kamper SJ, Gobina I, Ottova-Jordan V, Maher CG. An international survey of pain in adolescents. BMC Public Health. 2014;14:447.
Kalichman L, Suri P, Guermazi A, Li L, Hunter DJ. Facet orientation and tropism: association with facet joint osteoarthritis and degeneratives. Spine.2009;34(16):579-85.
Kamper SJ, Henschke N, Hestbaek L, Dunn KM, Williams CM. Musculoskeletal pain in children and adolescent. Braz J PhysTher. 2016;20(3):275-84.
Hancock MJ, Maher CG, Latimer J, Spindler MF, McAuley JH, Laslett M, et al. Systematic review of tests to identify the disc. SIJ or facet joint as the source of low back pain. Eur Spine J. 2007;16(10):1539-50.
Mahato NK. Facet dimensions, orientation and symmetry at L5-S1 junction in lumbosacral transitional states. Spine. 2011;36(9):569-73.
Masharawi YM, Alperovitch-Najenson D, Steinberg N, Dar G, Peleg S, Rothschild B, et al. Lumbar facet orientation in spondylolysis: a skeletal study. Spine. 2007;32(6):176-80.
Wang J, Yang X. Age related changes in the orientation of lumbar facet joints. Spine. 2009;34(17):596-8.
Quint U, Wilke HJ. Grading of degenerative disk disease and functional impairment: imaging vs patho-anatomical findings. Eur Spine J. 2008;17(12):1705-13.
Arnoldi CC, Brodsky LE, Cauchoix J, Crock HV, Dommisse GF, Edgar MA, et al. Lumbar spinal stenosis and nerve root entrapment syndromes: definition and classification. Clin Orthop Relat Res. 1976;115:4-5.
Noren R, Trafimow J, Andersson GB, Huckman MS. The role of facet tropism and facet angle in disc degeneration. Spine. 1991;16(5):530-2.
Brailsford JH. Deformities of the lumbosacral region of the spine. Br J Surg. 1928;16:562-627.
Karacan I, Aydin T, Sahin Z, Cidem M, Koyuncu H, Aktas I et al. Facet angles in lumbar disc herniation: their relation to anthropometric features. Spine. 2004;29(10):1132-6.
Fujiwara A, Tamai K, An HS, Lim TH, Yoshida H, Kurihashi A et al. Orientation and osteoarthritis of the lumbar facet joint. Clin Orthop Relat Res. 2001;88:94.
Ishihara H, Matsui H, Osada R, Ohshima H, Tsuji H. Facet joint asymmetry as a radiologic feature of lumbar intervertebral herniation in children and adolescents. Spine. 1997;22(17):2001-4.
Pinheiro MB, Ferreira ML, Refshauge K, Ordonana JR ,Machado GC, Prado LR, et al. Symptoms of depression and risk of new episodes of low back pain: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2015;67(11):1591-603.
Kong MH, He W, Tsai YD, Chen NF,Keorochana G,Do DH et al. Relationship of facet tropism with degeneration and stability of functional spinal unit. Yonsei Med J. 2009;50(5):624-9.
- There are currently no refbacks.
Copyright (c) 2020 Ezgi Akar, AyÅŸegÃ¼l AkdoÄŸan Gemici
This work is licensed under a Creative Commons Attribution 4.0 International License.