The Relationship Between Sagittalization And Horizontalization Of Lumbar Facet Joints And Its Degeneration Individually

ObjectiveTo investigate variation trend of lumbar facet joint ’s(LFJ)sagittalization,horizontalization and degeneration with age,and to analyze the correlation between LFJ degeneration and LFJ sagittalization and the correlation between LFJ degeneration and LFJ horizontalization.To explore the relationship between the degree of sagittalization and horizontalization of LFJ and its degeneration,and provide relevant information for further study of lumbar degeneration.MethodsThis subject is a retrospective study.According to the inclusion and exclusion criteria,a total of 192 patients(including 96 males and 96 females)were randomly selected from the Picture Archiving and Communication Systems(PACS)of The First Affiliated Hospital of Zhengzhou University.All patients had undergone 64-slice spiral CT examination of the lumbar spine in the outpatient department and the physical examination center from January of 2015 to June of 2018.All subjects were divided into 6 groups based on age.Each group included 32 subjects(16 males and 16 females),of which group 1: 18-30 years old,group 2: 31-40 years old,group 3: 41-50 years old,group 4: 51-60 years old,group 5: 61-70 years old,group 6: 71-80 years old.On the CT images,the facet joint angle and the pedicle facet angle(P-F angle)of L3/4,L4/5 and L5/S1 of every subject in each group were measured.The severity of LFJ degeneration in the three lumbar segments of each group was further assessed on the CT images.Comparison was made between the difference of two angles as well as the degree of LFJ degeneration of the same segment among all age groups.The correlation between the two angles and age as well as the degree of LFJ degeneration of the same segment were analyzed respectively.ResultsA total of 192 samples were included in this study,including 96 males and 96 females with average age of(50.25 ± 17.27)years old,ranging from 18 to 80 years old.The L3/4 facet joint angle was(39.07±5.75)°;the P-F angle was(103.77±3.74)°.The L4/5 facet joint angle was(45.32±6.78)°,and the P-F angle was(105.87±4.32)°.The L5/S1 facet joint angle was(47.67±7.76)°,and the P-F angle was(106.02±4.95)°.There were significant differences in facet joint angle of three lumbar segments among different age groups(P < 0.05).Age was negatively correlated with facet joint angles of L3/4(r=-0.468,P=0.000),L4/5(r=-0.556,P=0.000)and L5/S1(r=-0.469,P=0.000),respectively.There were significant differences in P-F angle of three lumbar segments among different age groups(P < 0.05).Age was positively correlated with P-F angles of L3/4(r=0.456,P=0.000),L4/5(r=0.580,P=0.000)and L5/S1(r=0.434,P=0.000),respectively.There were significant differences in degeneration degree of facet joints at three lumbar segments among different age groups(P < 0.05).Age was positively correlated with degeneration degree of facet joints of L3/4(r = 0.769,P = 0.000),L4/5(r = 0.737,P = 0.000)and L5/S1(r = 0.727,P = 0.000),respectively.The degeneration degree of L3/4 facet joint was negatively correlated with L3/4 facet joint angle(r=-0.472,P=0.000),but was positively correlated with L3/4 P-F angle(r=0.444,P=0.000).The degeneration degree of L4/5 facet joint was negatively correlated with L4/5 facet joint angle(r=-0.421,P=0.000),but was positively correlated with L4/5 P-F angle(r=0.560,P=0.000).The degeneration degree of L5/S1 facet joint was negatively correlated with L5/S1 facet joint angle(r=-0.422,P=0.000),but was positively correlated with L5/S1 P-F angle(r=0.316,P=0.000).Conclusions1.The degeneration degree of lumbar facet joint,the sagittalization and horizontalization of lumbar facet joint increase with age.2.There is a correlation between the degree of degeneration of lumbar facet joint and the degree of its sagittalization and horizontalization respectively.The degree of sagittalization and horizontalization of lumbar facet joint increase as the degree of lumbar facet joint degeneration increases.3.It is possible that the main reason for the sagittalization and horizontalization of lumbar facet joint is the process of degenerative remodeling,instead of congenital structural variation.