Analysis of the Relationship between Ligamentum Flavum Thickening and Lumbar Segmental Instability, Disc Degeneration, and Facet Joint Osteoarthritis in Lumbar Spinal Stenosis
Study DesignCross-sectional study.PurposeTo investigate the relationship between ligamentum flavum (LF) thickening and lumbar segmental instability and disc degeneration and facet joint osteoarthritis.Overview of LiteraturePosterior spinal structures, including LF thickness, play a major role in lum...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2016-12-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-10-1132.pdf |
| _version_ | 1811319490698280960 |
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| author | Toyomi Yoshiiwa Masashi Miyazaki Naoki Notani Toshinobu Ishihara Masanori Kawano Hiroshi Tsumura |
| author_facet | Toyomi Yoshiiwa Masashi Miyazaki Naoki Notani Toshinobu Ishihara Masanori Kawano Hiroshi Tsumura |
| author_sort | Toyomi Yoshiiwa |
| collection | DOAJ |
| description | Study DesignCross-sectional study.PurposeTo investigate the relationship between ligamentum flavum (LF) thickening and lumbar segmental instability and disc degeneration and facet joint osteoarthritis.Overview of LiteraturePosterior spinal structures, including LF thickness, play a major role in lumbar spinal canal stenosis pathogenesis. The cause of LF thickening is multifactorial and includes activity level, age, and mechanical stress. LF thickening pathogenesis is unknown.MethodsWe examined 419 patients who underwent computed tomography (CT) myelography and magnetic resonance imaging after complaints of clinical symptoms. To investigate LF hypertrophy, 57 patients whose lumbar vertebra had normal disc heights at L4–5 were selected to exclude LF buckling as a hypertrophy component. LF thickness, disc space widening angulation in flexion, segmental angulation, presence of a vacuum phenomenon, and lumbar lordosis at T12–S1 were investigated. Disc and facet degeneration were also evaluated. Facet joint orientation was measured via an axial CT scan.ResultsThe mean LF thickness in all patients was 4.4±1.0 mm at L4–5. There was a significant correlation between LF thickness and disc degeneration; LF thickness significantly increased with severe disc degeneration and facet joint osteoarthritis. There was a tendency toward increased LF thickness in more sagittalized facet joints than in coronalized facet joints. Logistic regression analysis showed that LF thickening was influenced by segmental angulation and facet joint osteoarthritis. Patient age was associated with LF thickening.ConclusionsLF hypertrophy development was associated with segmental instability and severe disc degeneration, severe facet joint osteoarthritis, and a sagittalized facet joint orientation. |
| first_indexed | 2024-04-13T12:43:11Z |
| format | Article |
| id | doaj.art-d702bad7a10047228d62af52365baf14 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-04-13T12:43:11Z |
| publishDate | 2016-12-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-d702bad7a10047228d62af52365baf142022-12-22T02:46:27ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462016-12-011061132114010.4184/asj.2016.10.6.113240Analysis of the Relationship between Ligamentum Flavum Thickening and Lumbar Segmental Instability, Disc Degeneration, and Facet Joint Osteoarthritis in Lumbar Spinal StenosisToyomi Yoshiiwa0Masashi Miyazaki1Naoki Notani2Toshinobu Ishihara3Masanori Kawano4Hiroshi Tsumura5Department of Orthopaedic Surgery, Oita University Faculty of Medicine, Yufu, Japan.Department of Orthopaedic Surgery, Oita University Faculty of Medicine, Yufu, Japan.Department of Orthopaedic Surgery, Oita University Faculty of Medicine, Yufu, Japan.Department of Orthopaedic Surgery, Oita University Faculty of Medicine, Yufu, Japan.Department of Orthopaedic Surgery, Oita University Faculty of Medicine, Yufu, Japan.Department of Orthopaedic Surgery, Oita University Faculty of Medicine, Yufu, Japan.Study DesignCross-sectional study.PurposeTo investigate the relationship between ligamentum flavum (LF) thickening and lumbar segmental instability and disc degeneration and facet joint osteoarthritis.Overview of LiteraturePosterior spinal structures, including LF thickness, play a major role in lumbar spinal canal stenosis pathogenesis. The cause of LF thickening is multifactorial and includes activity level, age, and mechanical stress. LF thickening pathogenesis is unknown.MethodsWe examined 419 patients who underwent computed tomography (CT) myelography and magnetic resonance imaging after complaints of clinical symptoms. To investigate LF hypertrophy, 57 patients whose lumbar vertebra had normal disc heights at L4–5 were selected to exclude LF buckling as a hypertrophy component. LF thickness, disc space widening angulation in flexion, segmental angulation, presence of a vacuum phenomenon, and lumbar lordosis at T12–S1 were investigated. Disc and facet degeneration were also evaluated. Facet joint orientation was measured via an axial CT scan.ResultsThe mean LF thickness in all patients was 4.4±1.0 mm at L4–5. There was a significant correlation between LF thickness and disc degeneration; LF thickness significantly increased with severe disc degeneration and facet joint osteoarthritis. There was a tendency toward increased LF thickness in more sagittalized facet joints than in coronalized facet joints. Logistic regression analysis showed that LF thickening was influenced by segmental angulation and facet joint osteoarthritis. Patient age was associated with LF thickening.ConclusionsLF hypertrophy development was associated with segmental instability and severe disc degeneration, severe facet joint osteoarthritis, and a sagittalized facet joint orientation.http://www.asianspinejournal.org/upload/pdf/asj-10-1132.pdfDisc degenerationLigamentum flavum thicknessLumbar spineFacet orientation |
| spellingShingle | Toyomi Yoshiiwa Masashi Miyazaki Naoki Notani Toshinobu Ishihara Masanori Kawano Hiroshi Tsumura Analysis of the Relationship between Ligamentum Flavum Thickening and Lumbar Segmental Instability, Disc Degeneration, and Facet Joint Osteoarthritis in Lumbar Spinal Stenosis Asian Spine Journal Disc degeneration Ligamentum flavum thickness Lumbar spine Facet orientation |
| title | Analysis of the Relationship between Ligamentum Flavum Thickening and Lumbar Segmental Instability, Disc Degeneration, and Facet Joint Osteoarthritis in Lumbar Spinal Stenosis |
| title_full | Analysis of the Relationship between Ligamentum Flavum Thickening and Lumbar Segmental Instability, Disc Degeneration, and Facet Joint Osteoarthritis in Lumbar Spinal Stenosis |
| title_fullStr | Analysis of the Relationship between Ligamentum Flavum Thickening and Lumbar Segmental Instability, Disc Degeneration, and Facet Joint Osteoarthritis in Lumbar Spinal Stenosis |
| title_full_unstemmed | Analysis of the Relationship between Ligamentum Flavum Thickening and Lumbar Segmental Instability, Disc Degeneration, and Facet Joint Osteoarthritis in Lumbar Spinal Stenosis |
| title_short | Analysis of the Relationship between Ligamentum Flavum Thickening and Lumbar Segmental Instability, Disc Degeneration, and Facet Joint Osteoarthritis in Lumbar Spinal Stenosis |
| title_sort | analysis of the relationship between ligamentum flavum thickening and lumbar segmental instability disc degeneration and facet joint osteoarthritis in lumbar spinal stenosis |
| topic | Disc degeneration Ligamentum flavum thickness Lumbar spine Facet orientation |
| url | http://www.asianspinejournal.org/upload/pdf/asj-10-1132.pdf |
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