| Objective:To investigate the relationship between the angle of lumbar facet joint and degenerative lumbar spondylolisthesis (DLS) by measure and analysis the morphology of lumbar facet joint with X-ray and CT.Method:1. Inclusion criteria:From July 2008 to June 2010,60 patients (average age: 55.57±8.76 years) with DLS in the section of L4/5 were reviewed, from which the patients suffered lumbar fracture and spondylolysis were excluded; 57 cases (average age:53.74±9.42 years) without the DLS and low back pain were selected as control group;2. Measuring method:With the help of lateral X-ray images, measure the olisthe distance of L4/5 segment and sagittal diameter of the lower centrum to get Taillard index by formula in DLS group. Measure the angles of the facet joint(L3/4, L4/5, L5/S1) from CT image of both groups. Based on Fujiwara Standard, grade the degree of lumbar facet joint degeneration through the observation of CT bone window images in DLS group.3. Statistical analysis:Analysis the data with SPSS 17.0. Independent sample t-test was used to compare angels of facet joint in section of L3/4, L4/5 and L5/S1 between DLS group and control; One-way analysis of variance was used for comparison among the 3 subgroups gotten based on degenerative grade of facet joint (Fujiwara Standard) in DLS group; According to the degenerative grade of facet joint, compare the angels of facet joint with variance analysis; Do Linear correlation analysis between the degenerative grade of facet joint and the angels of facet joint in section of L4/5; Comparison between the grades of facet joint degeneration was completed with chi-square test. Analysis the relationship between the morphology of lumbar facet joint and DLS combined with literatures. Result:1. All of the degree of spondylolisthesis in L4/5 section belonged to grade I in DLS group. The average Taillard index was 0.1679±0.0365;2. The angle of the facet joint of L4/5 was less than control (33.07±12.17°vs. 49.45±11.43°, P<0.001), but there was no significant difference in the section of L3/4 and L5/S1 between both groups(36.05±9.09 vs.38.63±8.04,48.50±13.02 vs. 51.85±13.04, P>0.05);3. In DLS group, there was no correlation between the degree of spondylolisthesis(Taillard index) and the angle of the L4/5 facet joint (r=0.065, P> 0.05);4. According to the degenerative grade of facet joint in L4/5 section,4 cases rated as gradeⅡ,23 cases as gradeⅢand 33 cases as gradeⅣin DLS group, and the Taillard index were 0.1837±0.0418,0.1723±0.0370 and 0.1589±0.0343 respectively. There was no significant difference among each grade (P>0.05)5. There was significant correlation between the angle of lumbar facet joint and degeneration(P< 0.05);6.The degenerative grade of facet joint in DLS was severer than the control group(P<0.01).Conclusion:There were different degeneration of lumbar facet joint in patients with DLS; The angel of facet joint in the same section in patients with DLS was less than that of patients without spondylolisthesis; Significant correlation was found between the angle of lumbar facet joint and its degree of degeneration; The degenerative grade of facet joint was severer after DLS; The change of angel of lumbar facet joint was the result of DLS, but not the pathogenesis. |
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