The difference of facet joint morphology in lumbar spinal stenosis with or without degenerative spondylolisthesis
Objective To investigate the difference of facet joint morphology in lumbar spinal stenosis patients with or without degenerative spondylolisthesis.Methods The clinical data of 80 patients with degenerative lumbar spondylolisthesis(DLS)treated in our hospital from August 2021 to October 2022 were retrospectively analyzed.Among them,60 patients with L4-5 spondylolisthesis were classified as DLS-a group and 20 patients with L5-S1 spondylolisthesis were classified as DLS-b group.In addition,the clinical data of 80 patients with simple degenerative spinal stenosis(LSS)treated in the same period were collected.66 patients with L4-5 stenosis were classified as LSS-a group,and 14 patients with L5-S1 stenosis were classified as LSS-b group.Lumbar spondylolisthesis(Taillard index)was calculated by CT in all four groups.The articular angle,articulation-pedicle angle and articular facet orientation of L4-5 and L5-S1 segments were measured and compared by multi-plane reconstruction technique.The linear correlation between the angle of the facet joint and the degree of slip was analyzed.The degree of L4-5 and L5-S1 facet joint degeneration in DLS group and LSS group were observed under the same window width and position,graded and compared according to Kalichman L standard.Results The DLS group mostly had grade Ⅰ or Ⅱ spondylolisthesis,and female patients were more common.There were significant differences in L4-5 FJA and P-FA in DLS group compared with LSS group(P<0.05).The Taillard index in DLS group was correlated with P-FA(P<0.05).There was a significant difference between DLS group(47/58.75%)and LSS group(36/45.00%)in the number of cases with facet arthrotropism(FT)(P>0.05).There was no significant correlation between the severity of FT in DLS group and LSS group with FJA,P-FA and Taillard index(P>0.05).The degree of facet joint degeneration was significantly different between DLS group and LSS group(P<0.05).In DLS-a group,the degree of degeneration of the joint process was significantly correlated with P-FA and Taillard index(P<0.05).Conclusions The angle of facet joint is significantly different in lumbar stenosis patients with or without degenerative spondylolisthesis.Compared with LSS patients,DLS patients have smaller FJA and larger P-FA,that is,FJ in DLS patients tends to be more sagittal and horizontal than that in LSS patients.There is a linear relationship between Taillard index and P-FA,the larger the P-FA angle,the larger the Taillard index.FT is more likely to occur in DLS group than in LSS group.Severe FT indicates serious degeneration of facet joints.
NETL
NSTL
万方数据
