Three-dimensional digital measurement of the facet joint in normal and lumbar intervertebral disc herniation aged 13-18 years

Asian J Surg. 2021 Jun 19:S1015-9584(21)00305-5. doi: 10.1016/j.asjsur.2021.05.028. Online ahead of print.

ABSTRACT

BACKGROUND: Lumbar facet joint is an important element of spinal “three-joint complex”. Whether there is a relationship between strange structure of facet joint and adolescent lumbar disc herniation (ALDH) is nonetheless controversial, and the current research is mainly centered on adults.

OBJECTIVE: To find out the normal lumbar facet joints between 13 and 18 years old to provide anatomical basis for early diagnosis and therapy of lumbar disc herniation.

METHODS: CT imaging information of 32 sufferers with lumbar disc herniation aged from 13 to 18 years old in Inner Mongolia have been collected as the ALDH group, and 62 wholesome subjects in the equal period had been chosen as the normal group. Uncooked records of continuous scanning lumbar tomography pix were imported into MIMICS 21.0 for evaluation and size in DICOM format. The parameters include facet joint height, facet joint width, et al.

RESULTS: 1. The left and right transverse angle of L₅S₁ segment in the ALDH group were (52.41 ± 9.2) ° and (55.99 ± 10.91) ° (P < 0.05), and the differences were statistically significant. The right side is larger than the left side. 2. Facet joint thickness in L₃-L₅ segment of the normal group was significantly higher than that of male (1.63 ± 0.32) mm than that of female (1.38 ± 0.25) mm; In 16-18 years old group, comparison of facet joint cross-sectional area was statistically significant (22.1 ± 3.04) mm² in male than (18.92 ± 3.71) mm² in female. 3. In comparison between normal and ALDH group, there was significant difference in L_3-4 transverse angle (P < 0.05), L_4-5 facet joint height and facet joint thickness (P < 0.05), L₅S₁ facet joint thickness and transverse angle (P < 0.05).

CONCLUSION: When ALDH occurs in the L₅S₁ segment, there is a substantial difference between the left and right sides of the transverse angle, and there is a difference in the thickness and the facet joint cross-sectional area between males and females, which is generally larger in males than in females. Facet joint height is larger, transverse angle of left and right is asymmetric, inferior articular process is larger, and facet joint thickness is smaller can indicate that lumbar disc herniation is effortless to occur.

PMID:34158200 | DOI:10.1016/j.asjsur.2021.05.028