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Cervical facet joint degeneration

It has been demonstrated that articular facet degeneration can cause local strain alterations and induce neck pain.

A study aimed to quantify the biomechanical effects of normal and degenerated C5-C6 articular facets, and evaluate the correlation of mechanical strain between healthy and degenerated spine. A 3-dimensional finite element (FE) model of the C5-C6 cervical spine was developed [Model 0 (M0)]. The asymmetric models of C5-C6 bilateral articular facet joint were established separately to mimic articular facet joint degeneration. The capsule ligament stiffness of C5-C6 unilateral facet joint was altered with minimum and maximum threshold to simulate capsule ligaments' lesion and calcification [Model 1 (M1) and Model 2 (M2), respectively]. Besides, the cervical C5-C6 unilateral articular facet joint direction was changed by 5° and 10° forward to imitate the moderate joint hyperplasia and severe osteophyte (Model 3 and Model 4 respectively). M1 increased the rotation range of ipsilateral side (left), while M2 reduced, and both had limited effect on the contralateral side (right). The angle increased in Model 3 (M3) (61°) and Model 4 (M4) (55°) comparing to M0 during the axial rotation, and the angle of M4 was larger. M3 and M4 increased the nucleus pulposus pressure with and without controlled angular displacement during axial rotation. The pressure of nucleus pulpous increased during M1 rotating to the abnormal side but decreased when rotating to the other side, but the results of M2 were opposite. The capsule ligament stiffness made an impact on segmental mobility and vertebral spatial position, and the sagittal angle of articular facet joint exerted an influence on disc pressure distribution 1).

The discrepancies in the interpretation of CT and MRI data in the evaluation of facet tropism and arthrosis have given rise to questions regarding the reliability of comparisons of the two techniques. Using a 4-point scale, 3 blinded readers independently graded the severity of facet tropism and facet arthrosis of 79 cervical facet joints on axial T2-weighted and sagittal T1 and T2-weighted turbo spin echo images as well as the corresponding axial CT scans. All results were subjected to the kappa coefficient statistic for strength of agreement. In the assessment of the severity of facet arthrosis, intermethod agreement (weighted κ) between CT scanning with a moderate inter-rater reliability (range κ = 0.43-0.57) and MRI with fair inter-rater reliability (range κ = 0.23-0.38) was 0.76 and 0.43 for the severity of facet tropism and facet arthrosis, respectively. Intra-rater reliability for the severity of facet arthrosis was moderate to substantial for CT and was moderate for MRI scans. Intra-rater reliability for the severity of facet tropism was substantial to very good for CT and substantial for MRI scans. MRI can reliably determine the presence or degree of facet tropism but not facet arthrosis. Therefore, for a comprehensive assessment of cervical facet joint degeneration, both a CT and an MRI scan should be performed 2).

Wang HH, Wang K, Deng Z, Li XF, Qin YX, Zhan HS, Niu WX. Effects of facet joint degeneration on stress alterations in cervical spine C5-C6: A finite element analysis. Math Biosci Eng. 2019 Aug 14;16(6):7447-7457. doi: 10.3934/mbe.2019373. PubMed PMID: 31698622.
Xu C, Ding ZH, Xu YK. Comparison of computed tomography and magnetic resonance imaging in the evaluation of facet tropism and facet arthrosis in degenerative cervical spondylolisthesis. Genet Mol Res. 2014 May 30;13(2):4102-9. doi: 10.4238/2014.May.30.5. PubMed PMID: 24938702.
cervical_facet_joint_degeneration.txt · Last modified: 2019/11/12 09:12 by administrador