The Effects Of Disc Degeneration And Facet Joint Degeneration On The Instability Of Degenerative Cervical Spine

Background and ObjectiveThe cervical vertebra, disc, the articular facets of the zygapophyseal joints and ligaments are the composition of the functional unit,which is essential for the cervical vertebra. The instability of cervical vertebra would occur if anyone of them is destoried.In our study, we observed the degeneration of the facet joints and disc. Inorder to provide some useful data for clinical study, we studied the effect of the disc degeneration and Facet joint degeneration on the instability of the cervical vertebra.Methods and MaterialsWe have selected 66 patients from Out-Patient or In-Patient Department of First affiliated Hospital of Zhengzhou University.There are 32males,34 females,16-80years old,mean age 49.6,who has functional radiography,CT and MRI. We excluded the patients who has traumatic, inflammatory, tumour disorders congenital deformity, we also excluded the patients who had surgery on the cervical vertebra before. All of the patients were divided into two groups:the patients who have instability of the cervical vertebra or not. There were 21 patients with instability of the cervical vertebrae,11 males,10 females,21-80years old, mean age 50.6;There were 45 patients without instability of the cervical vertebrae,21males,24 females, 16-79 years old,,mean age 49.2.We divided the instability of the cervical vertebrae into three types:translatory instability, abnormal tilting and rotatory instability. We measured the orientation of Facet joints on the sagittal plane. According to the standardization of Atsushi Fujiwara and Thompson. The degeneration of the Facet joints and disc were classified into several grades.Three doctors measured all of the indices on the computer. We compared the orientation of Facet joints on the sagittal plane between the two groups, and studied the effect of Facet joint and disc degeneration on the instability of the cervical vertebra. In the study we use SPSS statistical software versionl5.0 as the tool of statistical analysis.Results:1.The angle of Facet joints on the sagittal plane between the two groups were analyzed,we found that there are conspicuous differences on the segements of C4 and C5(P<0.05).There were no differences between the other segments (P>0.05).2.Translatory instability and abnormal tilting were found more frequently in C3-4 than the other segements (P<0.05).And rotatory instability was found more frequently in C5 and C6 than the other segements (P<0.05).3.As the degeneration of Facet joint, the number of translatory instability and rotatory instability were less and less(P<0.05).The abnormal tilting instability was found more in the segments with slightly degeneration of Facet joint.But they have no conspicuous relationship in the statistical analysis.We found that no segement with translatory instability and abnormal tilting instability belongs to the grade 3Facet joint degeneration.And we found that no segement with translatory instability and rotatory instability belongs to the grade 2 Facet joint degeneration.Conclusion:1.The decrease of the angle of Facet joints on the sagittal plane have active effects on the the instability of the cervical vertebra.2.In the process of degeneration of Facet joint, the number of instability of the cervical vertebra decreases.3.There is no conspicuous relationship between the degeneration of disc and the instability of the cervical vertebra.At the same time,we observed that the degeneration of disc has a positive effect on the desearse of the height of the intervertebral space.