The correlation between exaggerated fluid in lumbar facet joints and degenerative spondylolisthesis: Prospective study of 52 patients

被引:35
作者
Caterini R. [1 ]
Mancini F. [1 ]
Bisicchia S. [1 ]
Maglione P. [1 ]
Farsetti P. [1 ]
机构
[1] Department of Orthopaedic and Traumatology, University of Rome Tor Vergata, Rome 00133
关键词
Facet degeneration; Facet fluid; Instability; Lumbar spine;
D O I
10.1007/s10195-011-0141-3
中图分类号
学科分类号
摘要
Background: Magnetic resonance imaging (MRI) is often used to evaluate low back pain; however, MRI in the supine position does not always reveal degenerative spondylolisthesis. The existence of a linear correlation between increased fluid in the facet joints seen on the supine axial T2 MRI of the lumbosacral spine and lumbar instability seen on standing lateral flexion-extension lumbosacral radiographs has recently been reported. The objective of this prospective study was to determine the incidence of increased fluid in the lumbar facet joints seen on the supine axial T2 MRI, and to evaluate the correlation of this finding with radiographic evidence of lumbar instability. Materials and methods: We prospectively analyzed weight-bearing flexion-extension lumbosacral radiographs and lumbosacral MRI in the supine position for 52 patients (mean age 64.7 years) seen at our institution for low back pain and/or radiculopathy. The statistical analysis was performed with Fisher's exact test. A difference was considered statistically significant if P < 0.05. Results: In all but 5 of the 52 patients, degenerative disc disease and facet joint disease were observed on the supine MRI of the lumbosacral spine. Fifteen patients had exaggerated fluid in the lumbar facets on the axial T2 MRI (28.8%). Radiographic signs of degenerative lumbar spondylolisthesis were observed in 12 patients (23.1%), and the degenerative spondylolisthesis was not evident on the supine sagittal MRI in 10 of these 12 patients (83.3%). Among these 12 patients, the axial T2 MRI showed exaggerated fluid in the facet joints at the corresponding level in 8 patients (66%). Increased fluid in the lumbar facet joints was present on the supine axial T2 MRI in 7 patients (13.4%), even though there were no radiographic signs of corresponding lumbar instability. Conclusion: We observed a statistical correlation between increased fluid in the lumbar facet joints on the supine axial T2 MRI and degenerative spondylolisthesis seen on standing lateral flexion-extension lumbosacral radiographs. © 2011 The Author(s).
引用
收藏
页码:87 / 91
页数:4
相关论文
共 22 条
[1]  
Quinnell R.C., Stockdale H.R., Flexion and extension radiography of the lumbar spine: A comparison with lumbar discography, Clinical Radiology, 34, 4, pp. 405-411, (1983)
[2]  
Bendo J.A., Ong B., Importance of correlating static and dynamic imaging studies in diagnosing degenerative lumbar spondylolisthesis, Am J Orthop, 30, pp. 247-250, (2001)
[3]  
Stokes I.A.F., Frymoyer J.W., Segmental motion and instability, Spine, 12, 7, pp. 688-691, (1987)
[4]  
Ben-Galim P., Reitman C.A., The distended facet sign: An indicator of position-dependent spinal stenosis and degenerative spondylolisthesis, Spine Journal, 7, 2, pp. 245-248, (2007)
[5]  
Fujiwara A., Lim T., An H.S., Et al., The effect of disc degeneration and facet joint osteoarthritis on segmental flexibility of the lumbar spine, Spine, 23, pp. 3036-3044, (2000)
[6]  
Murata M., Morio Y., Kuranobu K., Lumbar disc degeneration and segmental instability: A comparison of magnetic resonance images and plain radiographs of patients with low back pain, Archives of Orthopaedic and Trauma Surgery, 113, 6, pp. 297-301, (1994)
[7]  
Bram J., Zanetti M., Min K., Hodler J., MR abnormalities of the intervertebral disks and adjacent bone marrow as predictors of segmental instability of the lumbar spine, Acta Radiologica, 39, 1, pp. 18-23, (1998)
[8]  
Grobler L.J., Robertson P.A., Novotny J.E., Pope M.H., Etiology of spondylolisthesis: Assessment of the role played by lumbar facet joint morphology, Spine, 18, 1, pp. 80-91, (1993)
[9]  
Grogan J., Nowicki B.H., Schmidt T.A., Haughton V.M., Lumbar facet joint tropism does not accelerate degeneration of the facet joints, American Journal of Neuroradiology, 18, 7, pp. 1325-1329, (1997)
[10]  
Schellinger D., Wener L., Ragsdale B.D., Et al., Facet joint disorders and their role in the production of back pain and sciatica, Radiographics, 7, pp. 923-944, (1987)