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Conference Paper: Facet Joint Tropism and Degenerative Spondylolisthesis—A Study from the AOSAP Research Collaboration

TitleFacet Joint Tropism and Degenerative Spondylolisthesis—A Study from the AOSAP Research Collaboration
Authors
Issue Date2014
PublisherGeorg Thieme Verlag. The Journal's web site is located at http://www.thieme.com/index.php?page=shop.product_details&flypage=flypage.tpl&product_id=1351&category_id=90&option=com_virtuemart&Itemid=53
Citation
World Forum for Spine Research (WFSR), Xi'an, China,15-17 May 2014. In Global Spine Journal, 2014, v. 4 n. Suppl. 1, p. S10-S11, abstract no. ST3.07 How to Cite?
AbstractIntroduction Degenerative spondylolisthesis (dSpl) is translation of the vertebral body in relation to adjacent levels, mainly attributed to degenerative changes of the intervertebral disc and facet joint complexes, and primarily occurs at L4-L5. Studies have suggested that more sagittal oriented facet joints at L4-L5 are associated with dSpl. However, the role of facet joint tropism (i.e., asymmetry between facet joint orientations) in L4-L5 dSpl remains inconclusive, in particular, in an Asian population and possibly attributed to nonstandardized definitions of tropism. As such, the following study addressed the role of facet joint tropism in relation to L4-L5 dSpl in the Asia Pacific region. Materials and Methods A multinational, multiethnic cross-sectional image-based study was performed in 34 institutions in the Asia Pacific region. Lateral standing radiographs and axial MRIs and/or CT scans were obtained for patients diagnosed with lumbar dSpl. Imaging assessment consisted of the following: magnitude of slip displacement, level of spondylolisthesis, and left/right L4- L5 facet joint angulations were noted on image assessment. Patients with single level dSpl were included. Patients were further stratified into those presenting with (Group A) or without (Group B) L4-L5 dSpl. Facet joint tropismwas defined as 7 degrees difference (Grogan et al 1997) between left and right facet joints and also assessed on receiver operating characteristics (ROC) curve analysis to identify critical values for multivariate analysis. Gender, age, weight/height (body mass index [BMI]), and ethnicity were also noted. Results The study included 351 patients (36.9% males and 63.1% females) with a mean age of 61.8 years (range: 24-90 years). The mean BMIwas 25.6 kg/m2 (range: 15.4-43.9 kg/m2). There were 267 patients (76.1%) in Group A and 84 individuals (23.9%) in Group B (control). Sex type (p ¼ 0.295) and BMI (p ¼ 0.227) did not significantly differ between groups, but elevated age was more pronounced with L4-L5 dSpl (p ¼ 0.001). There was a statistically significant difference between right and left L4-L5 facet joint angulations between Group A (right mean: 57.5 degrees; left mean: 55.4 degrees) and Group B (right mean: 48.4 degrees; left mean: 46.5 degrees) (p < 0.001). Based on facet joint tropism of 7 degrees difference between facet angulations, there was no statistically significant difference between groups. ROC analysis identified high sensitivity and specificity of facet joint angulation difference of 15 degrees or greater associated with dSpl. Based on ageadjusted multivariate analysis, facet joint tropism with a critical value of 15 degrees or greater angulation difference noted an odds ratio of 2.34 (95% CI: 1.17-4.67; p ¼ 0.016) associated with dSpl. Slippage was noted with increased facet joint tropism, but the effects could not be discerned. Conclusion Greater sagittal FJ orientationwas associated with dSpl, aswas joint tropism. A critical value of 15 degrees FJ angle difference produced a twofold increased likelihood of dSpl. Our study broadens the understanding of FJ morphology and its role in degenerative sagittal plane instability. Acknowledgments This study was funded by AOSpine Asia Pacific. Disclosure of Interest None declared
DescriptionConference theme: The Intervertebral Disc - from Degeneration to Therapeutic Motion Preservation
Short Talk Session
The abstract can be viewed at http://www.spineresearchforum.org/WFSR_2014_Thieme_AbstractBook_with_Cover.pdf
Persistent Identifierhttp://hdl.handle.net/10722/204385
ISSN
2015 SCImago Journal Rankings: 0.108

 

DC FieldValueLanguage
dc.contributor.authorSamartzis, Den_US
dc.contributor.authorRajasekaran, Sen_US
dc.contributor.authorKawaguchi, Yen_US
dc.contributor.authorAcharya, Sen_US
dc.contributor.authorKawakami, Men_US
dc.contributor.authorSatoh, Sen_US
dc.contributor.authorChen, Wen_US
dc.contributor.authorPark, Cen_US
dc.contributor.authorLee, Cen_US
dc.contributor.authorFoocharoen, Ten_US
dc.contributor.authorNagashima, Hen_US
dc.contributor.authorKuh, Sen_US
dc.contributor.authorZheng, Zen_US
dc.contributor.authorCondor, Ren_US
dc.contributor.authorIto, Men_US
dc.contributor.authorIwasaki, Men_US
dc.contributor.authorJeong, JHen_US
dc.contributor.authorLuk, KDKen_US
dc.contributor.authorPrijambodo, Ben_US
dc.contributor.authorRege, Aen_US
dc.contributor.authorJahng, Ten_US
dc.contributor.authorLuo, Zen_US
dc.contributor.authorTassanawipas, W/Aen_US
dc.contributor.authorAcharya, Nen_US
dc.contributor.authorPokharel, Ren_US
dc.contributor.authorShen, Yen_US
dc.contributor.authorIto, Ten_US
dc.contributor.authorZhang, Zen_US
dc.contributor.authorAithala, Jen_US
dc.contributor.authorKumar, GVen_US
dc.contributor.authorJabir, RAen_US
dc.contributor.authorBasu, Sen_US
dc.contributor.authorLi, Ben_US
dc.contributor.authorMoudgil, Ven_US
dc.contributor.authorSham, PLMen_US
dc.contributor.authorWilliams, Ren_US
dc.date.accessioned2014-09-19T22:41:29Z-
dc.date.available2014-09-19T22:41:29Z-
dc.date.issued2014en_US
dc.identifier.citationWorld Forum for Spine Research (WFSR), Xi'an, China,15-17 May 2014. In Global Spine Journal, 2014, v. 4 n. Suppl. 1, p. S10-S11, abstract no. ST3.07en_US
dc.identifier.issn2192-5682-
dc.identifier.urihttp://hdl.handle.net/10722/204385-
dc.descriptionConference theme: The Intervertebral Disc - from Degeneration to Therapeutic Motion Preservation-
dc.descriptionShort Talk Session-
dc.descriptionThe abstract can be viewed at http://www.spineresearchforum.org/WFSR_2014_Thieme_AbstractBook_with_Cover.pdf-
dc.description.abstractIntroduction Degenerative spondylolisthesis (dSpl) is translation of the vertebral body in relation to adjacent levels, mainly attributed to degenerative changes of the intervertebral disc and facet joint complexes, and primarily occurs at L4-L5. Studies have suggested that more sagittal oriented facet joints at L4-L5 are associated with dSpl. However, the role of facet joint tropism (i.e., asymmetry between facet joint orientations) in L4-L5 dSpl remains inconclusive, in particular, in an Asian population and possibly attributed to nonstandardized definitions of tropism. As such, the following study addressed the role of facet joint tropism in relation to L4-L5 dSpl in the Asia Pacific region. Materials and Methods A multinational, multiethnic cross-sectional image-based study was performed in 34 institutions in the Asia Pacific region. Lateral standing radiographs and axial MRIs and/or CT scans were obtained for patients diagnosed with lumbar dSpl. Imaging assessment consisted of the following: magnitude of slip displacement, level of spondylolisthesis, and left/right L4- L5 facet joint angulations were noted on image assessment. Patients with single level dSpl were included. Patients were further stratified into those presenting with (Group A) or without (Group B) L4-L5 dSpl. Facet joint tropismwas defined as 7 degrees difference (Grogan et al 1997) between left and right facet joints and also assessed on receiver operating characteristics (ROC) curve analysis to identify critical values for multivariate analysis. Gender, age, weight/height (body mass index [BMI]), and ethnicity were also noted. Results The study included 351 patients (36.9% males and 63.1% females) with a mean age of 61.8 years (range: 24-90 years). The mean BMIwas 25.6 kg/m2 (range: 15.4-43.9 kg/m2). There were 267 patients (76.1%) in Group A and 84 individuals (23.9%) in Group B (control). Sex type (p ¼ 0.295) and BMI (p ¼ 0.227) did not significantly differ between groups, but elevated age was more pronounced with L4-L5 dSpl (p ¼ 0.001). There was a statistically significant difference between right and left L4-L5 facet joint angulations between Group A (right mean: 57.5 degrees; left mean: 55.4 degrees) and Group B (right mean: 48.4 degrees; left mean: 46.5 degrees) (p < 0.001). Based on facet joint tropism of 7 degrees difference between facet angulations, there was no statistically significant difference between groups. ROC analysis identified high sensitivity and specificity of facet joint angulation difference of 15 degrees or greater associated with dSpl. Based on ageadjusted multivariate analysis, facet joint tropism with a critical value of 15 degrees or greater angulation difference noted an odds ratio of 2.34 (95% CI: 1.17-4.67; p ¼ 0.016) associated with dSpl. Slippage was noted with increased facet joint tropism, but the effects could not be discerned. Conclusion Greater sagittal FJ orientationwas associated with dSpl, aswas joint tropism. A critical value of 15 degrees FJ angle difference produced a twofold increased likelihood of dSpl. Our study broadens the understanding of FJ morphology and its role in degenerative sagittal plane instability. Acknowledgments This study was funded by AOSpine Asia Pacific. Disclosure of Interest None declared-
dc.languageengen_US
dc.publisherGeorg Thieme Verlag. The Journal's web site is located at http://www.thieme.com/index.php?page=shop.product_details&flypage=flypage.tpl&product_id=1351&category_id=90&option=com_virtuemart&Itemid=53-
dc.relation.ispartofGlobal Spine Journalen_US
dc.rightsGlobal Spine Journal. Copyright © Georg Thieme Verlag.-
dc.titleFacet Joint Tropism and Degenerative Spondylolisthesis—A Study from the AOSAP Research Collaborationen_US
dc.typeConference_Paperen_US
dc.identifier.emailSamartzis, D: dspine@hku.hken_US
dc.identifier.emailLuk, KDK: hrmoldk@hkucc.hku.hken_US
dc.identifier.emailSham, PLM: phoesham@hku.hken_US
dc.identifier.authoritySamartzis, D=rp01430en_US
dc.identifier.hkuros238035en_US
dc.identifier.hkuros238053-
dc.identifier.volume4-
dc.identifier.issueSuppl. 1-
dc.identifier.spageS10, abstract no. ST3.07-
dc.identifier.epageS11, abstract no. ST3.07-
dc.publisher.placeGermanyen_US

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