Correlation Between Bone Mineral Density And Lumbar Facet Degeneration And Parameters In Patients With Facet Arthrogenic Low Back Pain

Purpose:To investigate the effect of bone mineral density on the parameters related to facet facet and the degree of facet degeneration in patients with facet arthrogenic lumbago.Methods:The lumbar CT data of 85 patients with small articular low back pain were retrospectively analyzed.The patients were divided into three groups according to the bone mineral density measured by dual-energy X-ray absorptiometry(DXA): normal bone mineral density group(21 cases),osteopenia group(45 cases)and osteoporosis group(19 cases).The articular process area of lumbar facet joints at L4-L5 was measured and the degree of articular process degeneration was assessed from lumbar axial CT images(cross-sectional CT images of facet joints).The articular process height was measured by sagittal CT images of facet joints.Observation and measurement were performed using Siemens Syngo.Via VB20 A medical image processing software.The patients’ general condition(gender,age,body mass index),upper articular process area,articular process height,and articular process degeneration score were analyzed,and statistical software SPSS 27 was used for statistical processing and analysis.Results:The age difference of bone mineral density groups was statistically significant(P <0.001),and there was a statistically significant difference between the two groups after using LSD method(p < 0.05).The area of left and right superior articular process and the height of articular process were significantly different among the three groups(p < 0.001).However,there was no significant difference in the area of the right superior articular process between the normal bone density group and the decreased bone mass group(P >0.05).Kruskal-Wallis H rank sum test(Kruskal-Wallis H rank sum test)was used for statistical analysis of the relationship between bone density and articular process grading,and multiple comparisons were made afterwards,The results showed a statistical difference among the three groups(p < 0.001),and paired comparison results were p <0.001.There was a significant positive correlation between BMD and the grade of articular process degeneration at different ages.There were significant differences in the area and height of the upper articular process among all groups(p < 0.05).Conclusions:In patients with facet arthrogenic low back pain,bone mineral density reduction is often accompanied by aggravation of facet degeneration of the lumbar spine and an increase in the area and height of the upper articular process,which is most obvious in osteoporosis.The influence of bone mass loss on vertebral bone tissue is direct.When bone mass loss reaches a serious degree and bone mechanical insufficiency occurs,the stability of articular process is further changed and osteophytes are formed,which has an indirect influence on the degeneration and parameters of lumbar facet joint process.