| Background: Facet joint osteoarthritis is an important cause of low back pain. It has been reported that 15%-40% of low back pain may be caused by FJOA. However,due to the neglect of facet joint osteoarthritis in clinical work, the study of it is less.The gold standard diagnosis of lumbar facet joint osteoarthritis is facet injection,but it is invasive and need to operation under fluoroscopy. Radiographic examination is noninvasive and convenient, it plays an important role in the diagnosis of lumbar facet joint osteoarthritis in clinical work. Researchers had proposed different method for evaluating degeneration of facet joint, but research on their accuracy is less and inconsistent. The objective of this study is to detect the accuracy of different radiographic classifications by analysing the correlation between pathologic and radiographic grading of lumbar facet joint degeneration, and select the accurate method for evaluating facet joint degeneration.Lumbar facet joint osteoarthritis is a comment spinal degenerative disease, but its pathogenesis has not been expounded, especially its biological mechanism.Adiponectin is a kind of adipocytokines. In the knee OA, researchers had found that adiponectin can inhibit the expression of inflammatory factors, promote the expression of anti-inflammatory factors, and delay the progress of OA. However,some researchers suggested that adiponectin may promote the expression of matrix metalloproteinases and destroy the cartilage. The role of adiponectin in the lumbar facet joint osteoarthritis has not yet to be reported. Therefore, the objective of this study is to search the correlation between the pathologic grading and expression of adiponectin of the lumbar facet joints from low back pain patients and to explore the role of adiponectin in lumbar facet joint osteoarthritis.This research will study from the following two parts:1. The correlation between pathologic and radiographic grading of lumbar facet joint osteoarthritisObjective: To detect the accuracy of different radiographic classifications byanalysing the correlation between pathologic and radiographic grading of lumbar facet joint degeneration. Taking the pathologic grading as standard to compare the consistency of CT and MRI assessments of lumbar facet joint degeneration. Methods:74 facet joints obtained from 42 patients who received posterior lumbar surgery were evaluated in this research. All the patients underwent CT and MRI scanning before operation. The pathologic grade was evaluated by the method which was promoted by Gries after HE staining and toluidine blue staining. The radiographic grade was evaluated using the methods proposed by different authors. Results: The consistency of pathologic and radiographic grading for facet joint degeneration was moderate.The weighted kappa coefficients between pathologic and radiographic grading were0.506 for CT, 0.561 for MR, 0.592 for CT combined with MR grading respectively.Taking the pathologic examination as standard, the consistency of CT and MRI examination was also moderate, and the weighted kappa coefficient was 0.459.Conclusion: The radiographic examination has moderate accuracy for evaluating degeneration of facet joint. CT and MRI classification has different features, should not be substituted for each other. Therefore, further research to propose a more accurate method for evaluating the degeneration of facet joint is necessary.2. The correlation between pathologic grading and expression of adiponectin of lumbar facet joint osteoarthritisObjective: To search the correlation between the pathologic grading and expression of adiponectin of the lumbar facet joints from low back pain patients.Detecting the expression of inflammation cytokines to explore the role of adiponectin and inflammation cytokines in lumbar facet joint osteoarthritis. Methods: 47 facet joints obtained from 34 patients who received posterior lumbar surgery were evaluated in this research. All patients underwent CT and MRI before operation. The pathologic grade was evaluated by the method which was promoted by Gries after HE staining and toluidine blue staining. Using enzyme linked immunosorbent assay(ELISA) to measure the content of adiponectin in the lumbar facet joints cartilage. The inflammation cytokines chip was used to detect the expression of inflammation cytokines. Results: The adiponectin concentration in grading 2 groupwas more than grading 3(P < 0.001) and grading 4 group(P< 0.001), grading 3group was more than grading 4, but there was no significant statistical differences(P=0.245). The expression of 23 different inflammation cytokines had rise in degenerative facet joints. Conclusion: Adiponectin may slow down the progress of facet joints osteoarthritis by inhibiting the expression of inflammatory cytokines.However, the mechanism needs further research. |
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