facet_joint_violation

Facet joint violation

Grade 0 Screw not in facet

Grade 1 Screw in lateral facet but not in facet articulation

Grade 2 Penetration of facet articulation by screw

Grade 3 Screw travels within facet articulation

Shah RR, Mohammed S, Saifuddin A, Taylor BA. Radiologic evaluation of adjacent superior segment facet joint violation following transpedicular instrumentation of the lumbar spine. Spine (Phila Pa 1976). 2003 Feb 1;28(3):272-5. doi: 10.1097/01.BRS.0000042361.93572.74. PMID: 12567030.

A: Grade 0. no facet joint violation; B: Grade 1. Hardware within 1 mm from or abutting the facet joint, without clear joint involvement; C: Grade 2. Pedicle screw clearly within the facet joint; D: Grade 3. Pedicle screw head/ connector/ rod clearly within the facet joint.


Studies report the rates of facet joint violation in open procedures to be 24%-100% depending on the specific screw insertion technique utilized 1) 2) 3)

152 patients of lumbar spinal stenosis treated with percutaneous pedicle screw placement were enrolled in a study. facet joint violation (FJV) was evaluated on 3-dimensional lumbar CT reconstruction. Three types of grading systems were used to evaluate FJV: Babu's system (grading by the severity of violation), Shah's system (grading by side of violation), and modified Park's system (grading by different components to cause violation). The violation rate and observer consistency of the 3 grading systems were analyzed. Clinical outcomes were evaluated by visual analog score (VAS), Oswestry disability index (ODI) score.

Kappa coefficients of interobserver consistency on Babu, Shah, and Park grading systems were 0.726,0.849,0.692, respectively. The violation rate of Babu, Shah, and Park grading systems were comparable, which were 34.54%, 32.57%, 33.55%, respectively. In all 3 grading systems, the postoperative VAS low-back pain and ODI scores in non-FJV groups were lower than those in FJV groups (P < .05), and there were no significant differences between 2 groups in VAS leg pain(P >.05).

Babu, Shah and modified Park grading system are reliable grading systems, and it reported comparable violation rate. The self-reported clinical outcomes of patients with FJV were worse at 2-year follow-up. For clinical application, it is recommended to use 2 or even 3 different grading systems together to evaluate the FJV 4) 152 patients of lumbar spinal stenosis treated with percutaneous pedicle screw placement were enrolled in a study. facet joint violation (FJV) was evaluated on 3-dimensional lumbar CT reconstruction. Three types of grading systems were used to evaluate FJV: Babu's system (grading by the severity of violation), Shah's system (grading by side of violation), and modified Park's system (grading by different components to cause violation). The violation rate and observer consistency of the 3 grading systems were analyzed. Clinical outcomes were evaluated by visual analog score (VAS), Oswestry disability index (ODI) score.

Kappa coefficients of interobserver consistency on Babu, Shah, and Park grading systems were 0.726,0.849,0.692, respectively. The violation rate of Babu, Shah, and Park grading systems were comparable, which were 34.54%, 32.57%, 33.55%, respectively. In all 3 grading systems, the postoperative VAS low-back pain and ODI scores in non-FJV groups were lower than those in FJV groups (P < .05), and there were no significant differences between 2 groups in VAS leg pain(P >.05).

Babu, Shah and modified Park grading system are reliable grading systems, and it reported comparable violation rate. The self-reported clinical outcomes of patients with FJV were worse at 2-year follow-up. For clinical application, it is recommended to use 2 or even 3 different grading systems together to evaluate the FJV 5)


1)
Chen Z, Zhao J, Xu H, Liu A, Yuan J, Wang C. Technical factors related to the incidence of adjacent superior segment facet joint violation after transpedicular instrumentation in the lumbar spine. Eur Spine J. 2008;17(11):1476–1480.
2)
Moshirfar A, Jenis LG, Spector LR, et al. Computed tomography evaluation of superior-segment facet-joint violation after pedicle instrumentation of the lumbar spine with a midline surgical approach. Spine (Phila Pa 1976) 2006;31(22):2624–2629.
3)
Shah RR, Mohammed S, Saifuddin A, Taylor BA. Radiologic evaluation of adjacent superior segment facet joint violation following transpedicular instrumentation of the lumbar spine. Spine (Phila Pa 1976) 2003;28(3):272–275.
4) , 5)
Zhao Y, Yuan S, Liu W, Tian Y, Liu X. Clinical Validity of 3 Different Grading Systems for Facet Joint Violation: A Retrospective Study and In-Depth Review. Global Spine J. 2021 Apr 20:21925682211006028. doi: 10.1177/21925682211006028. Epub ahead of print. PMID: 33878942.
  • facet_joint_violation.txt
  • Last modified: 2021/04/23 09:17
  • by administrador