Natural history of the lumbar facet joint angle and onset of spondylolisthesis over 10 years — The International Society for the Study of the Lumbar Spine
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Natural history of the lumbar facet joint angle and onset of spondylolisthesis over 10 years (#ZO6)

Takehiro Watanabe 1 , Koji Otani 1 , Kenji Kobayashi 1 , Miho Sekiguchi 1 , Shinichi Konno 1
  1. Fukushima medical university, Fukushima City, FUKUSHIMA, Japan

INTRODUCTION

Sagittalization of the facet joints angle (FJA) has been suggested to be related to aging and lumbar spondylolisthesis by cross sectional studies. However, there have been no reports of long-term follow-up study for sagittalization of FJA evaluated by MRI in the community residents.

METHODS

This study included 294 participants (91 men, 203 women, mean age 64 years) with an age ranged from 28 to 91 years old in local residents in 2004. 120 of 294 patients received follow-up MRI in 2015. FAJ was measured in the axial image at each intervertebral disc level (L1/2-L5/S). Spondylolisthesis was defined as a vertebral body slipping more than 3mm on mid-line sagittal image. Statistical analysis was performed by Mann-Whitney U test and p values less than 0.05 were statistically significant difference.

RESULT

  1. In 2004, the FJA tended to be larger in the lower intervertebral disc level and tended to be smaller at each intervertebral disc level with age. In the group with spondylolisthesis (n=57), FJA of slipped intervertebral disc level tended to be smaller than that of the same disc level in the group without spondylolisthesis (n=237).
  2. In 2015, 27 patients (23%) (31 intervertebral disc level) showed the development of spondylolisthesis (L1/2: 1, L2/3: 3, L3/4: 7, L4/5: 15, L5/S1: 5). In the development of spondylolisthesis group, the average of FJA tended to increase in L1/2 and L2/3, and decrease in L3/4, L4/5 and L5/S compared with FJA in 2004, but there were no statistically significant differences.
  3. In the new spondylolisthesis onset subjects, 13 intervertebral disc levels (42%) had remarkably decreased FJA (ΔFJA<-5°), while 7 joints (23%) had increased FJA (ΔFJA>5°). These 7 intervertebral disc levels showed severe facet OA.


DISCUSSION

This study was the first to report the long-term course of FTJ. In this study, it was found that sagittalization of the facet joint progresses with age, regardless of the development of spondylolisthesis. Decreased FJA, which means sagittalization of the FJA, generally is thought to be essential for the development of spondylolisthesis, however, 23% of subjects with the development of spondylolisthesis showed increased FJA. This finding means that other factors except for sagittalization of FJA might have a strong influence on the development of spondylolisthesis. Further study is needed to determine the factors of the development of spondylolisthesis.

 

CONCLUSION

 

A tendency for sagittalization of FJA was observed over 10 years. However, in some cases with the development of spondylolisthesis, sagittalization was decreasing.

 

 

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