The Correlation Between Facet Tropism and Intervertebral Disc Herniation in the Subaxial Cervical Spine
The Correlation Between Facet Tropism and Intervertebral Disc Herniation in the Subaxial Cervical Spine
复制标题
颈椎小关节向性与椎间盘突出症的相关性
DOI：
10.1097/brs.0000000000003788
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发表时间：
2021-03-01
期刊：
影响因子：
3
通讯作者：
Teng，Honglin
中科院分区：
文献类型：
--
作者：
Wang，Yu;Chen，Guoliang;Teng，Honglin
研究设计。目的：探讨关节突向性（FT）与下轴颈椎间盘突出症（CDH）的关系。背景资料摘要。尽管存在争议，但FT与腰椎间盘突出症相关的报道已被广泛报道。然而，FT与亚轴性CDH之间的确切相关性尚不清楚。本研究纳入200例C3/4、C4/5、C5/6或C6/7椎间盘突出患者和50例无CDH的正常受试者（正常对照组）。对于患者，将宫颈CDH水平与未疝出水平分别分为“疝出组”和“患者对照组”。在计算机断层扫描（CT）上测量双侧C3/4、C4/5、C5/6和C6/7在矢状面、轴状面和冠状面上的关节角度。采用磁共振成像（MRI）对各阶段椎间盘退变情况进行评估。无论在C3/4、C4/5、C5/6或C6/7水平，无论在矢状面、轴状面或冠状面，疝组左右关节突角度和向向性发生率的平均差异均显著大于两个对照组。大多数患者对照组的角度和倾向性发生率的平均差异不显著大于相应的正常对照组。在左、中、右疝组中，左侧或右侧关节突角增大的发生率无显著差异。结论：矢状面、轴状面、冠状面FT均与颈椎下轴部CDH相关。左侧或右侧较大的关节突角不影响侧边的突出。颈椎间盘退变的严重程度与ft无关。证据水平：3测量了颈椎间盘突出（CDH）患者和健康参与者的下颈椎左、右关节突关节角。矢状面、轴状面和冠状面均与CDH有关，但与颈椎下轴位椎间盘退变无关。
Study Design.A retrospective case–control study.Objective.Investigating the correlation between the facet tropism (FT) and subaxial cervical disc herniation (CDH).Summary of Background Data.Although debatable, it was widely reported that FT was associated with lumbar disc herniation. However, the exact correlation between FT and subaxial CDH is still unclear.Methods.Two-hundred patients with any disc herniation at C3/4, C4/5, C5/6, or C6/7 and 50 normal participants without CDH (normal control group) were included in this study. For patients, the cervical levels with CDH and the levels without herniation were classified into the “herniation group” and “patient control group,” respectively. Bilateral facet joint angles at C3/4, C4/5, C5/6, and C6/7 on sagittal, axial, and coronal planes were measured on computed tomography (CT). The disc degeneration at each level was assessed on magnetic resonance imaging (MRI).Results.Both the mean difference between left and right facet angles and tropism incidence in herniation group were significantly greater than those in two control groups whenever at C3/4, C4/5, C5/6, or C6/7 level and whenever on sagittal, axial, or coronal plane. The mean differences of angles and tropism incidences in most patient control groups were not significantly greater than those of corresponding normal control groups. The incidence of greater facet angle at the left or right side was not significantly different among the left, central, and right herniation groups. The mean disc degeneration grades in both herniation and patient control groups were significantly higher than those in normal control groups while no difference between herniation and patient control groups.Conclusion.The FT on the sagittal, axial, and coronal planes are all associated with CDH in the subaxial cervical spine. The greater facet angle at the left or right side does not affect the side of herniation. The severity of cervical disc degeneration is not associated with FT.Level of Evidence: 3Left and right facet joint angles in the subaxial cervical spine of patients with cervical disc herniation (CDH) and healthy participants were measured. The facet tropism on the sagittal, axial, and coronal planes are all associated with CDH but not the disc degeneration in the subaxial cervical spine.