The Characteristics Of The Lumbar Facet Joint Degeneration Anatomical Observation And The Correlation Between Disc Degeneration MRI Study

The research consist the following two experiments:1The characteristics of the lumbar facet joint degeneration anatomicalobservationObjective: To observation and research the joint surface morphology structure changescharacteristics and its variation in the degenerative process of lumbar facet joint byanatomy terms, and to investigate the forming mechanism.Methods: Choose20adult cadavers consisting of15males and5females which fixed byformalin, the death age is20to80years old(average age is56.7),of which5bodies are20to40years old,7bodies are40to60years old(2bodies are female),8bodies are60to80years old(3bodies are female),on the basis of this age bracket,the bodies divided intoA,B,C three groups.The adult cadavers were anatomic cut into levels, T12-S1segmentwere complete separated, eliminate body muscle and fascia tissue which around thevertebral,expose small joint, make an incision through the capsule with a sharp knife, payattention to not damage the articular surface, expose the facet surface, observe andresearch the joint surface degeneration characteristics. Main evaluation parametersincluding:①The facet shape: Watch carefully the right and left facet shapes of eachlumbar segment.②Transverse and sagittal diameters of the facet: Use vernier calipermeasure transverse diameter and sagittal diameters of different types facet.③Articularcartilage degeneration features: Use the magnifying glass observe the articular cartilage,record according to four degrees and five districts.④The distribution of cartilagedefects: Observe the distribution of cartilage defects,record according to five district,calculate the proportion of each regions.⑤The distribution of osteophytes: Observe thedistribution of osteophytes on the edge of the articular surface, record according to fourdegrees, calculate the proportion of each regions.Compare the difference of each parameters on the above between superior andinferior facet and different region of the articular surface (the superior, medio-ventral,latero-dorsal, inferior,and the central zone), Study the changing trend of each parameter in different age bracket and lumbar segment, research the distribution regulation anddiscuss the forming mechanism.Results:①Horizontal plane from the point of view, T12/L1segment mainly of shape“1” and“C”, L1/2, L2/3, L3/4, L4/5segments with“C” and“J” shapesof the main, at L5/S1segment is“1” shape, no significant difference between left andright side each sections, from the sagittal view, all segments of the articular surface areshape“1”.②Transverse and sagittal diameters: Articular surface transverse and sagittaldiameters from T12/L1to L5/S1segments gradually increased,There is no significantdifference between left and right facet and superior and inferior facet of the same segment,but in different age groups each segment transverse and sagittal diameters havedifferences, the overall trend is that with the increase of age and degeneration, facet joints,transverse and sagittal diameter gradually increased.③Cartilage degeneration: A higherincidence of cartilage degeneration in the lumbar facet joint, closely related to age, studieshave shown that degeneration was not obvious before the age of40, significantdegeneration at age40, after the age of60regressive become more and more serious; andthe degree of degeneration increased with the increment of lumbar segments, whichinvolved the most serious for the L4/5, at L5/S1segment; cartilage degeneration mainlyoccurred in the articular surface of the surrounding area, while the central area of thecartilage is relatively well preserved.④Cartilage defects: The incidence of cartilagedefects in superior articular process from high to low were: superior (65%), inferior(52%), latero-dorsal (47%), medio-ventral (39%) and central zone (12%), the inferiorarticular process were: inferior (61%), superior (56%), latero-dorsal (49%),medio-ventral (43%), and central zone (17%).⑤Osteophytosis: Mainly in thesurrounding area of the articular surface, it is a relative lower incidence compared withcartilage defects, in the more serious degeneration of the joints, osteophytosis at higherrates; the osteophytosis incidence from high to low in superior facet were: latero-dorsal(30.3%), superior (11.5%), inferior (5.1%), medio-ventral (2.3%), the inferior facetwere: inferior (16.5%), latero-dorsal (5.7%), superior(3.2%), medio-ventral (1.1%).Conclusions:①The articular cartilage degeneration and osteophytes are the mainperformance of facet joint degeneration on lumbar spine, this performance will aggravating with the age increase and the lumbar segment move down.②This researchrevealed the distribution regulation of lumbar facet joint degeneration between superiorand inferior facet and different region of articular surface. and revealed the changing trendin different age bracket and lumbar motion segments.③The characteristic lumbar facetjoint degeneration relate to the morphology of facies articularis, the stress between joints,this reflect the human body’s structure adaptability and destructive change under longload condition; Understand the characteristics and the changing rule is beneficial toresearch facet joint’s normal physiology and related disease for us.2The correlation between lumbar facet joint degeneration andintervertebral disc degeneration MRI studyObjective：To investigate the correlation between age and lumbar facet joint degenerationand intervertebral disc degeneration by MRI performance characteristics.Methods: Collect MRI imaging datas of90cases who with lumbar intervertebral discsdegeneration, the age from20to80years old, average age is53.6years old, divide intothree groups:20-40years old，41-60years old，61-80years old, each group of30cases. Toanalyzed and studied MRI performances about L3/4,L4/5, L5/S1motion segments’lumbar intervertebral discs and facet joint. according to the Pfirrmann standard, discdegeneration is divided intoⅠ,Ⅱ,Ⅲ,Ⅳ,Ⅴgrades, according to the Fujiwara standard,lumbar facet joint degeneration is divided into1,2,3,4grades. Three experiencedorthopaedic physicians classified record the radiographic, Take the average of threegroups..All the data were analyzed by Pearson correlation of SPSS13.0. to analyse thecorrelation between age and lumbar facet joint degeneration and intervertebral discdegeneration.Results:①Age and lumbar facet joint degeneration and the disc degeneration werepositively correlated(r=0.782，r=0.810，P=0.000), as the age increasing, the degree oflumbar facet joint degeneration and disc degeneration gradually increased.②Lumbarintervertebral disc degeneration happened earlier than the facet joint degeneration,Thedegeneration between lumbar facet joint and lumbar intervertebral disc were positivelycorrelated(r=0.813，P=0.000).The higher degree of lumbar intervertebral disc degeneration, the more serious of facet joint degeneration performance.Conclusions:①Natural aging and abnormal stress is the main reason for lumbar facetjoint degeneration and disc degeneration.②Lumbar facet joint degeneration and discdegeneration reinforce each other, mutual influence, induce and accelerate each otherdegenerative process in the entire lumbar degeneration occurs.③Lumbar facet joint anddisc to maintain spinal stability, both in anatomy, pathophysiology and biomechanics ofmutual contact. In lumbar spine surgery should take into account both the integrity andunity, to avoid excessive destruction of joints and attention to restore the intervertebralheight, so as not to cause new instability, accelerated spinal degeneration.