Display options
Cite
Samartzis D, Cheung JP, Rajasekaran S, et al. Is lumbar facet joint tropism developmental or secondary to degeneration? An international, large-scale multicenter study by the AOSpine Asia Pacific Research Collaboration Consortium. Scoliosis Spinal Disord. 2016;11:9doi: 10.1186/s13013-016-0062-2.
Samartzis, D., Cheung, J. P., Rajasekaran, S., Kawaguchi, Y., Acharya, S., Kawakami, M., Satoh, S., Chen, W. J., Park, C. K., Lee, C. S., Foocharoen, T., Nagashima, H., Kuh, S., Zheng, Z., Condor, R., Ito, M., Iwasaki, M., Jeong, J. H., Luk, K. D., Prijambodo, B., Rege, A., Jahng, T. A., Luo, Z., Tassanawipas, W. A., Acharya, N., Pokharel, R., Shen, Y., Ito, T., Zhang, Z., Aithala P, J., Kumar, G. V., Jabir, R. A., Basu, S., Li, B., Moudgil, V., Goss, B., Sham, P., & Williams, R. (2016). Is lumbar facet joint tropism developmental or secondary to degeneration? An international, large-scale multicenter study by the AOSpine Asia Pacific Research Collaboration Consortium. Scoliosis and spinal disorders, 119. https://doi.org/10.1186/s13013-016-0062-2
Samartzis, Dino, et al. "Is lumbar facet joint tropism developmental or secondary to degeneration? An international, large-scale multicenter study by the AOSpine Asia Pacific Research Collaboration Consortium." Scoliosis and spinal disorders vol. 11 (2016): 9. doi: https://doi.org/10.1186/s13013-016-0062-2
Samartzis D, Cheung JP, Rajasekaran S, Kawaguchi Y, Acharya S, Kawakami M, Satoh S, Chen WJ, Park CK, Lee CS, Foocharoen T, Nagashima H, Kuh S, Zheng Z, Condor R, Ito M, Iwasaki M, Jeong JH, Luk KD, Prijambodo B, Rege A, Jahng TA, Luo Z, Tassanawipas WA, Acharya N, Pokharel R, Shen Y, Ito T, Zhang Z, Aithala P J, Kumar GV, Jabir RA, Basu S, Li B, Moudgil V, Goss B, Sham P, Williams R. Is lumbar facet joint tropism developmental or secondary to degeneration? An international, large-scale multicenter study by the AOSpine Asia Pacific Research Collaboration Consortium. Scoliosis Spinal Disord. 2016 Feb 09;11:9. doi: 10.1186/s13013-016-0062-2. eCollection 2016. PMID: 27252985; PMCID: PMC4888515.
Copy Download .nbib Format: NLM
Share it on

Scoliosis Spinal Disord. 2016 Feb 09;11:9. doi: 10.1186/s13013-016-0062-2. eCollection 2016.

Is lumbar facet joint tropism developmental or secondary to degeneration? An international, large-scale multicenter study by the AOSpine Asia Pacific Research Collaboration Consortium.

Scoliosis and spinal disorders

Dino Samartzis, Jason Pui Yin Cheung, Shanmuganathan Rajasekaran, Yoshiharu Kawaguchi, Shankar Acharya, Mamoru Kawakami, Shigenobu Satoh, Wen-Jer Chen, Chun-Kun Park, Chong-Suh Lee, Thanit Foocharoen, Hideki Nagashima, Sunguk Kuh, Zhaomin Zheng, Richard Condor, Manabu Ito, Motoki Iwasaki, Je Hoon Jeong, Keith D K Luk, Bambang Prijambodo, Amol Rege, Tae-Ahn Jahng, Zhuojing Luo, Warat Anant Tassanawipas, Narayana Acharya, Rohit Pokharel, Yong Shen, Takui Ito, Zhihai Zhang, Janardhana Aithala P, Gomatam Vijay Kumar, Rahyussalim Ahmad Jabir, Saumyajit Basu, Baojun Li, Vishal Moudgil, Ben Goss, Phoebe Sham, Richard Williams

Affiliations

  1. Department of Orthopaedics & Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, SAR China.
  2. Department of Orthopaedics, Ganga Hospital, Coimbatore, India.
  3. Department of Orthopaedic Surgery, University of Toyama, Toyama, Japan.
  4. Department of Orthopedics, Sir Gangaram Hospital, New Delhi, India.
  5. Spine Center, Wakayama Medical University, Kihoku Hospital, Ito-gun, Japan.
  6. Department of Spine Surgery, Eniwa Hospital, Hokkaido, Japan.
  7. Orthopaedic Department, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  8. Department of Neurosurgery, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, South Korea.
  9. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
  10. Department of Orthopaedic Surgery, Khonkaen Regional Hospital, Khonkean, Thailand.
  11. Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Yonago, Japan.
  12. Department of Neurosurgery, Gangnam Severance Hospital, Seoul, South Korea.
  13. Department of Spine Surgery, The First Hospital Affiliated of Zhongshan University, Guangzhou, China.
  14. Department of Orthopedics, Cebu Orthopaedic Institute, Cebu, Philippines.
  15. Department of Advanced Medicine for Spine and Spinal Cord Disorders, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
  16. Department of Orthopaedic Surgery, Osaka Rosai Hospital, Osaka, Japan.
  17. Department of Neurosurgery, College of Medicine, Soon Chun Hyang Unviersity Bucheon Hospital, Bucheon, South Korea.
  18. Department of Orthopaedic and Traumatology, Faculty of Medicine Airlargga University, Dr Soetomo Teaching Hospital, Surabaya, Indonesia.
  19. Department of Orthopaedics, Deenanath Mangeshkar Hospital, Jehangir Hospital, Pune, India.
  20. Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
  21. Spine Service, Department of Orthopaedic Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, China.
  22. Department of Orthopedics, Phramongkuthklao Army Hospital, Bangkok, Thailand.
  23. Dwaraka Institute of Spine Care, Bellary, India.
  24. Department of Orthopedics & Trauma Surgery, Spine Unit, Tribhuvan University, Teaching Hospital, Kathmandu, Nepal.
  25. Department of Spine Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
  26. Department of Orthopaedic Surgery, Niigata City General Hospital, Niigata, Japan.
  27. Department of Orthopaedic Surgery, Beijing 361 Hospital (Aviation General Hospital), Beijing, China.
  28. Department of Orthopedics, Kasturba Medical College, Manipal University, Mangalore, India.
  29. Department of Neurosurgery, Fortis Hospital, Kolkata, India.
  30. Orthopaedic and Traumatology Department, University of Indonesia / RS Ciptomangunkusumo, Jakarta, Indonesia.
  31. Neurosciences Division, Park Clinic, Kolkata, India.
  32. Department of Orthopedic, Punjab Institute of Medical Sciences Jalandhar, Jalandhar, India.
  33. Department of Orthopaedics, University of Queensland, Brisbane, Australia.

PMID: 27252985 PMCID: PMC4888515 DOI: 10.1186/s13013-016-0062-2

Abstract

BACKGROUND: Facet joint tropism is asymmetry in orientation of the bilateral facets. Some studies have shown that tropism may increase the risk of disc degeneration and herniations, as well as degenerative spondylolisthesis (DS). It remains controversial whether tropism is a pre-existing developmental phenomena or secondary to progressive remodeling of the joint structure due to degenerative changes. As such, the following study addressed the occurrence of tropism of the lower lumbar spine (i.e. L3-S1) in a degenerative spondylolisthesis patient model.

METHODS: An international, multi-center cross-sectional study that consisted of 349 patients with single level DS recruited from 33 spine institutes in the Asia Pacific region was performed. Axial MRI/CT from L3-S1 were utilized to assess left and right facet joint sagittal angulation in relation to the coronal plane. The angulation difference between the bilateral facets was obtained. Tropism was noted if there was 8° or greater angulation difference between the facet joints. Tropism was noted at levels of DS and compared to immediate adjacent and distal non-DS levels, if applicable, to the index level. Age, sex-type and body mass index (BMI) were also noted and assessed in relation to tropism.

RESULTS: Of the 349 subjects, there were 63.0 % females, the mean age was 61.8 years and the mean BMI was 25.6 kg/m(2). Overall, 9.7, 76.5 and 13.8 % had L3-L4, L4-L5 and L5-S1 DS, respectively. Tropism was present in 47.1, 50.6 and 31.3 % of L3-L4, L4-L5 and L5-S1 of levels with DS, respectively. Tropism involved 33.3 to 50.0 % and 33.3 to 58.8 % of the immediate adjacent and most distal non-DS levels from the DS level, respectively. Patient demographics were not found to be significantly related to tropism at any level (p > 0.05).

CONCLUSIONS: To the authors' knowledge, this is one of the largest studies conducted, in particular in an Asian population, addressing facet joint tropism. Although levels with DS were noted to have tropism, immediate adjacent and distal levels with no DS also exhibited tropism, and were not related to age and other patient demographics. This study suggests that facet joint tropism or perhaps subsets of facet joint orientation may have a pre-disposed orientation that may be developmental in origin or a combination with secondary changes due to degenerative/slip effects. The presence of tropism should be noted in all imaging assessments, which may have implications in treatment decision-making, prognostication of disease progression, and predictive modeling. Having a deeper understanding of such concepts may further elaborate on the precision phenotyping of the facets and their role in more personalized spine care. Additional prospective and controlled studies are needed to further validate the findings.

Keywords: AOSpine; Angulation; Developmental; Facet; Joints; Orientation; Spondylolisthesis; Tropism

References

  1. Spine (Phila Pa 1976). 2001 Mar 15;26(6):677-9 - PubMed
  2. Clin Orthop Relat Res. 2001 Apr;(385):88-94 - PubMed
  3. Int Orthop. 2001;25(1):40-2 - PubMed
  4. J Bone Joint Surg Am. 1975 Jun;57(4):467-74 - PubMed
  5. Spine (Phila Pa 1976). 2004 May 15;29(10):1132-6 - PubMed
  6. Spine (Phila Pa 1976). 2009 Jul 15;34(16):E579-85 - PubMed
  7. Eur Spine J. 2010 Apr;19(4):670-5 - PubMed
  8. J Spinal Disord Tech. 2010 Apr;23(2):101-5 - PubMed
  9. Spine (Phila Pa 1976). 1991 May;16(5):530-2 - PubMed
  10. Eur Spine J. 2011 Jan;20(1):71-8 - PubMed
  11. Spine (Phila Pa 1976). 2010 Oct 1;35(21):1944-52 - PubMed
  12. J Spinal Disord Tech. 2012 Apr;25(2):E18-22 - PubMed
  13. Evid Based Spine Care J. 2012 May;3(2):25-34 - PubMed
  14. Eur Spine J. 2013 May;22(5):1045-52 - PubMed
  15. Eur Spine J. 2013 Aug;22(8):1717-22 - PubMed
  16. Spine J. 2013 Oct;13(10):1301-8 - PubMed
  17. Spine J. 2014 Mar 1;14(3):479-82 - PubMed
  18. Spine J. 2015 Feb 1;15(2):230-7 - PubMed
  19. Spine J. 2015 Sep 1;15(9):1915-8 - PubMed
  20. Global Spine J. 2016 Feb;6(1):35-45 - PubMed
  21. Spine J. 2016 Sep;16(9):1079-89 - PubMed
  22. Global Spine J. 2016 Aug;6(5):414-21 - PubMed
  23. J Anat. 1986 Apr;145:87-96 - PubMed
  24. J Bone Joint Surg Am. 1972 Apr;54(3):492-510 - PubMed
  25. Spine (Phila Pa 1976). 1984 Sep;9(6):557-65 - PubMed
  26. Spine (Phila Pa 1976). 1983 Mar;8(2):122-30 - PubMed
  27. Spine (Phila Pa 1976). 1980 Mar-Apr;5(2):168-72 - PubMed
  28. Spine (Phila Pa 1976). 1978 Dec;3(4):319-28 - PubMed
  29. Spine (Phila Pa 1976). 1993 Jun 15;18(8):1000-5 - PubMed
  30. Spine (Phila Pa 1976). 1993 Jan;18(1):80-91 - PubMed
  31. J Bone Joint Surg Am. 1996 Mar;78(3):403-11 - PubMed
  32. Acta Orthop Belg. 1996 Jun;62(2):90-3 - PubMed
  33. AJNR Am J Neuroradiol. 1997 Aug;18(7):1325-9 - PubMed
  34. Eur Spine J. 1998;7(5):376-80 - PubMed

Publication Types