Asymmetric Facet Joint Osteoarthritis and Its Relationships to Facet Orientation, Facet Tropism and Ligamentum Flavum Thickening.
Asymmetric Facet Joint Osteoarthritis and its Relationships to Facet Orientation, Facet Tropism and Ligamentum Flavum Thickening.
Filed under: Rehab Centers
J Spinal Disord Tech. 2012 Nov 16;
Liu HX, Shen Y, Shang P, Ma YX, Cheng XJ, Xu HZ
STUDY DESIGN:: The degrees of osteoarthritis of the left and right facet joints were evaluated by using computerized tomography (CT) among elderly patients with low back or leg pain. OBJECTIVE:: To reveal the phenomenon of asymmetry regarding facet joint osteoarthritis (FJOA) in old patients and establish its relationships to spinal level, facet orientation, facet tropism and ligamentum flavum (LF) thickening. SUMMARY OF BACKGROUND DATA:: There were few reports regarding left-right asymmetry among severity of FJOA and its relationships to spinal level, facet orientation, facet tropism and LF thickening remained unclear. METHODS:: The grade of bilateral FJOA was evaluated using 4-grade scale on CT images at the L3-4, L4-5 and L5-S1 levels of patients with age from 60 to 80 years old. All subjects were divided into two groups: symmetric FJOA group (FJOA I-II on both sides or FJOA III-IV on both sides) and asymmetric FJOA group (FJOA I-II on one side and FJOA III-IV on the other side). The relationships of FJOA to spinal level, facet orientation, facet tropism, and LF hypertrophy were evaluated. RESULTS:: No association between asymmetric FJOA and spinal level was noted (P>0.05). In asymmetric FJOA group, significant difference in facet orientation between two sides was observed at the L4-5 (P=0.018) and L5-S1 levels (P=0.033). Compared with symmetric FJOA, asymmetric FJOA showed significant difference in prevalence of facet tropism at the L5-S1 level (P<0.001). The LF showed significantly thicker on the side of FJOA III-IV than the side of FJOA I-II at each level in asymmetric FJOA group (P<0.05). Meanwhile, no difference was found in thickness between two sides in symmetric FJOA group (P>0.05). CONCLUSIONS:: Asymmetric FJOA is associated with facet orientation and tropism, but not with spinal level. There is a close relationship between severity of FJOA and LF thickness.
HubMed – rehab
3D-FSE Isotropic MRI of the Lumbar Spine: Novel Application of an Existing Technology.
Filed under: Rehab Centers
J Spinal Disord Tech. 2012 Nov 16;
Blizzard DJ, Haims AH, Lischuk AW, Arunakul R, Hustedt JW, Grauer JN
STUDY DESIGN:: Retrospective diagnostic trial OBJECTIVE:: Determine the diagnostic performance of three-dimensional, isotropic fast/turbo spin-echo (3D-TSE) in routine lumbar spine MR imaging. SUMMARY OF BACKGROUND DATA:: Conventional 2D-FSE MRI requires independent acquisition of each desired imaging plane. This is time consuming and potentially problematic in spine imaging, as the plane of interest varies along the vertical axis due to lordosis, kyphosis, or possible deformity. 3D-TSE provides the capability to acquire volumetric datasets that can be dynamically reformatted to create images in any desired plane. METHODS:: Eighty subjects scheduled for routine lumbar MRI were included in a retrospective trial. Each subject underwent both 3D-TSE and conventional 2D-FSE axial and sagittal MRI sequences. For each subject, the 3D-TSE and 2D-FSE sequences were separately evaluated (minimum 4?wk apart) in a randomized order and read independently by four reviewers. Images were evaluated using specific criteria for stenosis, herniation, and degenerative changes. RESULTS:: The inter-method reliability for the four reviewers was 85.3%. Modified inter-method reliability analysis, disregarding disagreements between the lowest two descriptors for appropriate criteria (equivalent to “none” and “mild”), revealed average overall agreement of 94.6%. Using the above, modified criteria, inter-observer variability for 3D-TSE was 89.1% and 88.3% for 2D-FSE (P=0.05), and intra-observer variability for 3D-TSE was 87.2% and 82.0% for 2D-FSE (P<0.01). The inter-method agreement between 3D-TSE and 2D-FSE was statistically non-inferior to intra-observer 2D-FSE variability (P<0.01). CONCLUSIONS:: This systematic evaluation showed that there is a very high degree of agreement between diagnostic findings assessed on 3D-TSE and conventional 2D-FSE sequences. Overall, inter-method agreement was statistically non-inferior to the intra-observer agreement between repeated 2D-FSE evaluations. Overall, this study shows that 3D-TSE performs equivalently, if not superiorly to 2D-FSE sequences. Reviewers found particular utility for the ability to manipulate image planes with the 3D-TSE if there was greater pathology or anatomic variation. HubMed – rehab
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