Korean J Spine Search


Clinical Usefulness of Disc Degeneration and Facet Joint Degeneration as an Indicator of Judgment for Lumbar Segmental Instability.
Ho Bum Lee, Chan Jong Yoo, Chan Woo Park, Sang Gu Lee, Woo Kyung Kim
Department of Neurosurgery, Gachon University of Medical & Science, Gil Medical Center, Incheon, Korea. nschan@gilhospital.com
Treatment for symptomatic lumbar stenosis is usually surgical decompression and additional global fusion is recommended for patients with segmental instability. The aim of this article is to evaluate that degeneration degree of the disc and facet joint could be the indicator of judgment for segmental instability.
We retrospectively reviewed 84 patients who underwent surgical treatment for lumbar spinal stenosis. Patients in Group 1(30 patients) with radiological instability underwent decompression with global fusion, patients in Group 2(54 patients) without radiological instability underwent decompression with global fusion or decompression only according to the existence and nonexistence of clinical instability. Magnetic resonance images were used to assess the disc degeneration from Grade I(normal) to Grade V(advanced) and the facet joints degeneration from Grade 0(normal) to Grade 3(advanced). All patients were checked with the simple X-ray stress view and evaluated.
Severity of the disc degeneration had no significant association with the segmental instability, and no correlation with the facet joint degeneration. Severity of facet joint degeneration had significant correlation with the radiological instability. The segmental instability was increased with increasing severity of facet joint degeneration, especially tran slation. There was a significant association between facet joint degeneration and clinical instability. The facet joint degeneration was increased in patients with clinical instability.
Our results suggest that the facet joint degeneration may be the useful indicator of judgment for segmental instability
Keywords: Spinal stenosis;Facet joint osteoarthritis;Segmental instability

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