Abstract

BackgroundFacet tropism is the angular asymmetry between the left and right facet joint orientation. Although debatable, facet tropism was suggested to be associated with disc degeneration, facet degeneration and degenerative spondylolisthesis in the lumbar spine. The purpose of this study was to explore the relationship between facet tropism and facet degeneration in the sub-axial cervical spine.MethodsA total of 200 patients with cervical spondylosis were retrospectively analyzed. Facet degeneration was categorized into 4 grade: grade I, normal; grade II, degenerative changes including joint space narrowing, cyst formation, small osteophytes (<3 mm) without joint hypertrophy; grade III, joint hypertrophy secondary to large osteophytes (>3 mm) without fusion of the joint; grade IV, bony fusion of the facet joints. Facet orientations and facet tropisms with respect to the transverse, sagittal and coronal plane were calculated from the reconstructed cervical spine, which was based on the axial CT scan images. The paired facet joints were then categorized into three types: symmetric, moderated tropism and severe tropism. Univariate and multivariate analysis were performed to evaluate the relationship between any demographic and anatomical factor and facet degeneration.ResultsThe mean age of enrolled patients was 46.23 years old (ranging from 30 to 64 years old). There were 114 males and 86 females. The degrees of facet degeneration varied according to cervical levels and ages. Degenerated facet joints were most common at C2-C3 level and more common in patients above 50 years old. The facet orientations were also different from level to level. By univariate analysis, genders, ages, cervical levels, facet orientations and facet tropisms were all significantly different between the normal facets and degenerated facets. However, results from multivariate logistic regression suggested only age and facet tropism with respect to the sagittal plane were related to facet degeneration.ConclusionFacet degeneration were more common at C2-C3 level. Older age and facet tropism with respect to the sagittal plane were associated with the facet degeneration.

Highlights

  • Facet tropism is defined as the angular asymmetry between the left and right facet joint orientation [1]

  • T-angle the inclination of facets with respect to the transverse plane, S-angle the inclination of facets with respect to the sagittal plane, C-angle the inclination of facets with respect to coronal plane * P < 0.05 compared to the males ·¶ P < 0.05 compared to other levels No significant difference was noted between right side and left side analysis according to levels, we found that gender was only related to facet degeneration at C2-C3 level

  • Facet tropism was common in the sub-axial cervical spine

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Summary

Introduction

Facet tropism is the angular asymmetry between the left and right facet joint orientation. The purpose of this study was to explore the relationship between facet tropism and facet degeneration in the sub-axial cervical spine. Facet tropism is defined as the angular asymmetry between the left and right facet joint orientation [1]. Numerous clinical studies suggested that facet tropism could be the predisposing factor for some. Though, there has been no study evaluating the relationship between facet tropism and cervical facet degeneration, as far as we know. Rong et al BMC Musculoskeletal Disorders (2017) 18:86 synovial joints in the sub-axial cervical spine, which are of great importance guiding the spinal motion and transmitting the axial loading [13, 14]. The cervical facet joints degenerate with age, including cartilage thinning, osteophyte formation or hypertrophy, sclerosis and joint space narrowing [17,18,19]

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