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Orientation of the facet joints in degenerative rotatory lumbar scoliosis: an MR study on 52 patients

  • Clinical Article - Spine
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Abstract

Background

Because of a degenerative component, degenerative rotatory scoliosis seems different from congenital and idiopathic subtypes of the disease. This study aims to examine the orientation of facet joints, as a known cause of degeneration, in patients with degenerative rotatory scoliosis.

Methods

Lumbar magnetic resonance (MR) images and plain radiographs of 52 symptomatic patients (mean age, 50.17 years) with degenerative rotatory lumbar scoliosis (mean curve, 19.22 degrees) and 50 healthy individuals were reviewed. Facet joint angles in rotated segments and the minimum neural foramen width at all lumbar levels were measured by three observers and the average was recorded.

Results

The maximum vertebral rotation was most frequent at L4-L5 (75 %), and the majority was of type I (84.6 %) according to the Nash-Moe classification. At all lumbar spinal levels the mean facet joint angles were significantly higher on the side of rotation (L2-L3, 57.92 degrees; L3-L4, 45.00 degrees; L4-L5, 43.88 degrees) compared to those on the contralateral side (L2-L3, 20.42 degrees; L3-L4, 15.48 degrees; L4-L5, 13.12 degrees) and in controls (L2-L3, 30.21 degrees; L3-L4, 40.81 degrees; L4-L5, 45.20 degrees) (p < 0.001 for all comparisons). The mean facet joint angle increased significantly from L4-L5 to L2-L3 in cases and reversely in controls. The mean minimum neural foramen width was 1.29 ± 0.85 mm on the side of rotation, 5.50 ± 1.09 mm on the contralateral side, and 6.78 ± 1.75 mm in controls (p < 0.001).

Conclusions

Substantial asymmetries and abnormal orientations in facet joints were documented in patients with degenerative rotatory lumbar scoliosis. Such asymmetries may adversely affect neural foramen width.

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Authors and Affiliations

  1. Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Masoud Poureisa, Mohammad Hossein Daghighi & Leila Akhoondzadeh

  2. Department of Radiology, Zabol University of Medical Sciences, Zabol, Iran

    Razieh Behzadmehr

  3. Neurosciences Research Center, Tabriz University of Medical Sciences, Imam Reza Teaching Hospital, Golgasht Street, Tabriz, Iran

    Daniel Fadaei Fouladi

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  1. Masoud Poureisa
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  2. Razieh Behzadmehr
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Correspondence to Daniel Fadaei Fouladi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Poureisa, M., Behzadmehr, R., Daghighi, M.H. et al. Orientation of the facet joints in degenerative rotatory lumbar scoliosis: an MR study on 52 patients. Acta Neurochir 158, 473–479 (2016). https://doi.org/10.1007/s00701-015-2690-3

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  • DOI: https://doi.org/10.1007/s00701-015-2690-3

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