The relationship between facet tropism and lumbar disc herniation in patients with low back pain

Sima Fallah Arzpeyma; Parisa Hajir; Pooya Bahari Khorram; Sima Fallah Arzpeyma; Parisa Hajir; Pooya Bahari Khorram

doi:10.3934/medsci.2019.3.181

AIMS Medical Science

2019, Volume 6, Issue 3: 181-190. doi: 10.3934/medsci.2019.3.181

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The relationship between facet tropism and lumbar disc herniation in patients with low back pain

1.
Assistant Professor of Radiology, Radiology Department, Guilan University of Medical Sciences, Rasht, Iran
2.
Radiology Resident, Radiology Department, Guilan University of Medical Sciences, Rasht, Iran

Received: 11 May 2019 Accepted: 04 July 2019 Published: 26 July 2019

Introduction: Intervertebral disc herniation is a degenerative lumbar disease and a common pathology of skeletal system. Currently, most experts assume that facet tropism may affect lumbar degenerative diseases. However, the reports on relationship between facet tropism and lumbar disc herniation are inconsistent. Objective: To compare the relationship between facet tropism and lumbar disc herniation. Materials and Methods: In this cross-sectional study, patients with low back pain referring to Radiology Department of Poursina Hospital in 2017–2018 with lumbar disc herniation in only one intervertebral level (L3–L4, L4–L5 or L5–S1) were included. Using gradual sampling, patients were categorized into two case and control groups. Lumbar MRI was performed on all patients and the results were studied by only one professional radiologist. Studied variables were collected with a checklist and analyzed using SPSS software (version 21). Quantitative variables were compared using T-test and qualitative (categorical) variables were compared using Contingency Tables and Chi-Square test and/or Fisher’s Extract. P < 0.05 was identified statistically significant. Findings: Seventy-six patients with lumbar disc herniation were compared in terms of facet tropism presence. Investigating facet tropism in L4–L5 disc showed that percentage of facet tropism incidence in this level was 37% for patients with herniation (n = 10), while it was 10.2% in control group; the difference was statistically significant according to Chi-square test (P = 0.005). In L3-L4 level, percentage of facet tropism incidence in case and control groups were 43.8% (n = 7) and 18.3%, respectively. This 25% difference was statistically significant based on Fisher’s Exact test (P = 0.041). Findings for L5-S1 disc showed no significant relationship. Discussion: Given the inconsistent findings in previous studies on the relationship between facet tropism and lumbar disc herniation, the current study demonstrated the presence of this relationship. This findings can help experts prevent disc herniation to some extents through supportive and preventive measures.
- low back pain,
- facet tropism,
- lumbar vertebrae,
- intervertebral disc herniation,
- MRI
Citation: Sima Fallah Arzpeyma, Parisa Hajir, Pooya Bahari Khorram. The relationship between facet tropism and lumbar disc herniation in patients with low back pain[J]. AIMS Medical Science, 2019, 6(3): 181-190. doi: 10.3934/medsci.2019.3.181

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Abstract

Introduction: Intervertebral disc herniation is a degenerative lumbar disease and a common pathology of skeletal system. Currently, most experts assume that facet tropism may affect lumbar degenerative diseases. However, the reports on relationship between facet tropism and lumbar disc herniation are inconsistent. Objective: To compare the relationship between facet tropism and lumbar disc herniation. Materials and Methods: In this cross-sectional study, patients with low back pain referring to Radiology Department of Poursina Hospital in 2017–2018 with lumbar disc herniation in only one intervertebral level (L3–L4, L4–L5 or L5–S1) were included. Using gradual sampling, patients were categorized into two case and control groups. Lumbar MRI was performed on all patients and the results were studied by only one professional radiologist. Studied variables were collected with a checklist and analyzed using SPSS software (version 21). Quantitative variables were compared using T-test and qualitative (categorical) variables were compared using Contingency Tables and Chi-Square test and/or Fisher’s Extract. P < 0.05 was identified statistically significant. Findings: Seventy-six patients with lumbar disc herniation were compared in terms of facet tropism presence. Investigating facet tropism in L4–L5 disc showed that percentage of facet tropism incidence in this level was 37% for patients with herniation (n = 10), while it was 10.2% in control group; the difference was statistically significant according to Chi-square test (P = 0.005). In L3-L4 level, percentage of facet tropism incidence in case and control groups were 43.8% (n = 7) and 18.3%, respectively. This 25% difference was statistically significant based on Fisher’s Exact test (P = 0.041). Findings for L5-S1 disc showed no significant relationship. Discussion: Given the inconsistent findings in previous studies on the relationship between facet tropism and lumbar disc herniation, the current study demonstrated the presence of this relationship. This findings can help experts prevent disc herniation to some extents through supportive and preventive measures.

Acknowledgments

This article was extracted from a thesis approved in Guilan University of Medical Sciences. We greatly Vice Chancellor for Research of Guilan University of Medical Sciences for funding this project.

Conflict of interest

The author declares no conflicts of interest in this paper.

References

[1]	Katz JN (2006) Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Joint Surg Am 88: 21–24.
[2]	Adams MA, Roughley PJ (2006) What is intervertebral disc degeneration, and what causes it? Spine 31: 2151–2161. doi: 10.1097/01.brs.0000231761.73859.2c
[3]	Nachemson A (1960) Lumbar intradiscal pressure: experimental studies on post-mortem material. Acta Orthop Scand 31: 1–104.
[4]	Atlas SJ, Chang Y, Kammann E, et al. (2000) Long-term disability and return to work among patients who have a herniated lumbar disc: the effect of disability compensation. J Bone Joint Surg Am 82: 4–15. doi: 10.2106/00004623-200001000-00002
[5]	Vialle LR, Vialle EN, Henao JES, et al. (2010) Hérnia discal lombar Lumbar disc herniation. Rev Bras Ortop 45: 17–22. doi: 10.1590/S0102-36162010000100004
[6]	Jacobsen S, Sonne-Holm S, Rovsing H, et al. (2007) Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study. Spine 32: 120–125. doi: 10.1097/01.brs.0000250979.12398.96
[7]	Tulsi RS, Hermanis GM (1993) A study of the angle of inclination and facet curvature of superior lumbar zygapophyseal facets. Spine 18: 1311–1317. doi: 10.1097/00007632-199308000-00010
[8]	Lee DY, Lee SH (2009) Effects of facet tropism and disk degeneration on far lateral lumbar disk herniation: comparison with posterolateral lumbar disk herniation. Neurol Med Chir (Tokyo) 49: 57–61. doi: 10.2176/nmc.49.57
[9]	Brailsford JF (1929) Deformities of the lumbosacral region of the spine. Br J Surger 16: 562–627. doi: 10.1002/bjs.1800166405
[10]	Farfan H, Sullivan J (1967) The relation of facet orientation to intervertebral disc failure. Can J surg J can de chir 10: 179.
[11]	Kim HJ, Chun HJ, Lee HM, et al. (2013) The biomechanical influence of the facet joint orientation and the facet tropism in the lumbar spine. Spine J 13: 1301–1308. doi: 10.1016/j.spinee.2013.06.025
[12]	Cyron B, Hutton W (1980) Articular tropism and stability of the lumbar spine. Spine 5: 168–172. doi: 10.1097/00007632-198003000-00011
[13]	Chadha M, Sharma G, Arora SS, et al. (2013)Association of facet tropism with lumbar disc herniation. Eur Spine J 22: 1045–1052.
[14]	Farfan H, Cossette J, Robertson G, et al. (1970) The effects of torsion on the lumbar intervertebral joints: the role of torsion in the production of disc degeneration. J Bone Joint Surg Am 52: 468–497. doi: 10.2106/00004623-197052030-00006
[15]	Noren R, Trafimow J, Andersson G, et al. (1991) The role of facet joint tropism and facet angle in disc degeneration. Spine 16: 530–532. doi: 10.1097/00007632-199105000-00008
[16]	Ko HY, Park BK (1997) Facet tropism in lumbar motion segments and its significance in disc herniation. Arch Phys Medicin Rehabil 78: 1211–1214. doi: 10.1016/S0003-9993(97)90334-8
[17]	Linov L, Klindukhov A, Li L, et al. (2013) Lumbar facet joint orientation and osteoarthritis: a cross-sectional study. J Back Musculoskeletal Rehabil 26: 421–426. doi: 10.3233/BMR-130401
[18]	Van JS, Verbiest H, Van FS (1985) The orientation of laminae and facet joints in the lower lumbar spine. Spine 10: 59–63. doi: 10.1097/00007632-198501000-00009
[19]	Ahmed AM, Duncan NA, Burke DL (1990) The effect of facet geometry on the axial torque-rotation response of lumbar motion segments. Spine 15: 391–401. doi: 10.1097/00007632-199005000-00010
[20]	Vanharanta H, Floyd T, Ohnmeiss DD, et al. (1993) The relationship of facet tropism to degenerative disc disease. Spine 18: 1000–1005. doi: 10.1097/00007632-199306150-00008
[21]	Cassidy JD, Loback D, Yong-Hing K, et al. (1992) Lumbar facet joint asymmetry. Intervertebral disc herniation. Spine 17: 570–574.
[22]	Adams M, Hutton W (1981) The relevance of torsion to the mechanical derangement of the lumbar spine. Spine 6: 241–248. doi: 10.1097/00007632-198105000-00006
[23]	Yu H, Hou S, Wu W, et al. (1998) The relationship of facet orientation to intervertebral disc protrusion and lateral recess stenosis in lower lumbar spine. Zhonghua wai ke za zhi 36: 176–8, 31.
[24]	Grogan J, Nowicki BH, Schmidt TA, et al. (1997) Lumbar facet joint tropism does not accelerate degeneration of the facet joints. Am J Neuror 18: 1325–1329.
[25]	Gao T, Lai Q, Zhou S, et al. (2017) Correlation between facet tropism and lumbar degenerative disease: a retrospective analysis. BMC Musculoskeletal Disord 18: 483. doi: 10.1186/s12891-017-1849-x
[26]	Long DM, BenDebba M, Torgerson WS, et al. (1996) Persistent back pain and sciatica in the United States: patient characteristics. J Spinal Disord 9: 40–58.
[27]	Putti V (1927) New conceptions in the pathogenesis of sciatic pain. Lancet 2: 53–60.
[28]	Tisot RA, Vieira JDS, Collares DDS, et al. (2018) Influence of facet tropism on the location of lumbar disc herniation. Coluna/Columna 17: 23–26. doi: 10.1590/s1808-185120181701179264
[29]	Lumbar DDD (2013) Associação entre tropismo facetário e doença degenerativa de disco lombar.
[30]	Liu Z, Duan Y, Rong X, et al. (2017) Variation of facet joint orientation and tropism in lumbar degenerative spondylolisthesis and disc herniation at L4–L5: A systematic review and meta-analysis. Clin Neurol Neurosurgery 161: 41–47. doi: 10.1016/j.clineuro.2017.08.005
[31]	Mohanty SP, Kanhangad MP, Kamath S, et al. (2018) Zygapophyseal joint orientation and facet tropism and their association with lumbar disc prolapse. Asian Spine J 12: 902–909. doi: 10.31616/asj.2018.12.5.902
[32]	Wang H, Zhou Y (2016) Facet tropism: possible role in the pathology of lumbar disc herniation in adolescents. J Neurosurgery Pediatr 18: 111–115. doi: 10.3171/2015.7.PEDS15175
[33]	Pichaisak W, Chotiyarnwong C, Chotiyarnwong P (2015) Facet joint orientation and tropism in lumbar degenerative disc disease and spondylolisthesis. J Med Assoc Thai 98: 373–379.
[34]	Ghandhari H, Ameri E, Hasani H, et al. (2018) Is facet tropism associated with increased risk of disc herniation in the lumbar spine? Asian Spine J 12: 428. doi: 10.4184/asj.2018.12.3.428
[35]	Kunakornsawat S, Ngamlamaidt K, Tungsiripat R, et al. (2007) The relationship of facet tropism to lumbar disc herniation. J M ed Assoc Thai 90: 1337–1341.
[36]	Karacan I, Aydin T, Sahin Z, et al. (2004) Facet angles in lumbar disc herniation: their relation to anthropometric features. Spine 29: 1132–1136. doi: 10.1097/00007632-200405150-00016
[37]	Kong MH, He W, Tsai Y-D, et al. (2009) Relationship of facet tropism with degeneration and stability of functional spinal unit. Yonsei Med J 50: 624–629. doi: 10.3349/ymj.2009.50.5.624
[38]	Eun SS, Lee H-Y, Lee S-H, et al. (2012) MRI versus CT for the diagnosis of lumbar spinal stenosis. J Neuroradiology 39: 104–109. doi: 10.1016/j.neurad.2011.02.008
[39]	Videman T, Leppävuori J, Kaprio J, et al. (1998) Volvo award winner in basic science studies: Intragenic polymorphisms of the vitamin D receptor gene associated with intervertebral disc degeneration. Spine 23: 2477–2485. doi: 10.1097/00007632-199812010-00002
[40]	Battié MC, Videman T, Parent E (2004) Lumbar disc degeneration: epidemiology and genetic influences. Spine 29: 2679–2690. doi: 10.1097/01.brs.0000146457.83240.eb
[41]	Battié MC, Videman T, Gibbons LE, et al. (1995) Determinants of lumbar disc degeneration: a study relating lifetime exposures and magnetic resonance imaging findings in identical twins. Spine 20: 2601–2612. doi: 10.1097/00007632-199512150-00001
[42]	Cohen SP, Raja SN (2007) Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. Anesthesiology 106: 591–615. doi: 10.1097/00000542-200703000-00024

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