Association Between Facet Joint Asymmetry With Lumbar Disc Herniation And Protrusion Position In Adolescents

Objective:Lumbar facet joint asymmetry is thought to be associated with lumbar disc herniation(LDH),but the relationship between the two is unclear.In addition,the effect of vertebral facet joints on LDH has not been outlined in adolescent patients.The purpose of this study is to measure and compare the Angle of lumbar facet joints with computed tomography(CT),and to study the relationship between the asymmetry of vertebral facet joints with LDH as well as Herniated disc location in adolescent patients(12-21 years old).Methods:In this study,149 patients with single or two-segment lumbar disc herniation(L3～L4,L4～L5,or L5～S1)and 108 adolescent patients with acute abdomen(Acute appendicitis,acute cholecystitis,acute pancreatitis,acute intestinal obstruction,abdominal organ perforation)diagnosed in the First Affiliated Hospital of xx University from December 2016 to December 2022 were retrospectively analyzed as the study subjects,aged from 12 to 21 years old,the facet joint Angle(FJA)of the study subjects at L3 ～ 4,L4 ～ 5,L5 ～ S1 levels were measured and recorded by lumbar CT or abdominal CT,and the Angle difference of bilateral facet joint angle >7° was defined as facet tropism(FT).Analysis the association of lumbar facet joint asymmetry with adolescent lumbar disc herniation(ALDH)and the relationship between the position of intervertebral disc herniation with facet tropism.The measurement results were analyzed and processed by SPSS26.0 software,which could express the measurement values of normal distribution as mean ± standard deviation(x±s),while for measurement data without normal distribution,the median(upper and lower quiles)could be expressed.In addition,the rank sum test could also be used for intra-group comparison.The chi-square test can be used to count relative comparisons between groups of related data.P value less than 0.05 indicated that the difference was statistically significant.Result:Among 149 patients with lumbar disc herniation,57 patients had FT at the L3-4segment,77 patients had FT at the L4-5 segment,and 85 patients had FT at the L5-S1 segment,while 25,29,and 27 patients had FT at the L3-4,L4-5,and L5-S1 segments,respectively,in the 108 patients in the N-LDH group;the probability of FT was significantly higher in the experimental group relative to the control group(P < 0.05).In the LDH group,FT was present in 31 of 51 protrusions in the L4-5 segment,and56 of 97 protrusions in the L5-S1 segment;while the number of patients with FT in the L4-5,and L5-S1 segments was 29,and 27,respectively,in the 108 N-LDH group;the probability of FT in the experimental group was significantly higher than that in the control group(P< 0.05).In the LDH group,among the 51 cases of L4-5 disc herniation,18 cases of central type and 33 cases of paracentral type,9 cases of central type FT and 22 cases of paracentral type FT,Among the 97 cases of L5-S1 disc herniation,39 cases were of central type,58 cases were of paracentral type,11 cases were of central type FT and 45 cases were of paracentral type.By cardinal empirical comparison,vertebral subtotal joint asymmetry was correlated with the location of lumbar disc herniation in the L5-S1 segment(P < 0.05).Conclusion:Facet joint asymmetry was significantly associated with lumbar disc herniation at the L4-5 and L5-S1 segmentsin in adolescents,and facet joint asymmetry was associated with the location of lumbar disc herniation at the L5 ～ S1 segments in adolescents.