The Relationship Between The Morphology Of Lumbar Facet Joint With Degenerative Lumbar Spondylolisthesis

Objective:To investigate the relationship between lumbar facet joint morphology with degenerative lumbar spondylolisthesis and the role of the morphology of lumbar facet joint by measure and analysis the morphology of lumbar facet joint with X ray and CT.Methods:1.52 patients with degenerative lumbar spondylolisthesis(L4-5) were studied,whose ages ranged from 41 to 74 years old(the average age is 57.58±7.83years), male 14,female 38.collect their lumbar spine X ray and CT scanner image. Volunteers without low back pain or leg pain and ruled out degenerative spondylolisthesis were selected as the control group.2. Measurement of X ray:measure the degree of spondylolisthesis (Taillard index) and the angle of pedicle of vertebral arch and inferior articular process in the lateral radiograph.3. Measurement of CT: Bone window(Window width:2000; Window level:600), observe and grade the degree of degeneration;mearsure the coronal angle of facet joint.4. The coronal angle of the facet joint and the angle of pedicle of vertebral arch and inferior articular process between DS group and control group were compared; and the coronal angle of the L4-5 facet joint and the degree of spondylolisthesis of different grade of osteoarthritis were compared; correlation analysis between the degree of spondylolisthesis and the coronal angle of the L4-5 facet joint and age of patients; the morphology of Isthmic spondylolisthesis and degenerative spondylolisthesis were compared,to further investigate the role of the morphology of lumbar facet join played in degenerative spondylolisthesis.Results:1. The bilateral coronal angle of the displacement segment(L4-5) facet joints were significantly different in patients with DS group compared with controls group,but non-displacement segments(L3-4,L5-S1)have no different.2. There was no significant difference in the angle of pedicle of vertebral arch and inferior articular process of displacement segment(L4-5) between DS group and control group.3. there was no significant difference in the orientation of the L4-5 facet joint of different grade of osteoarthritis, while the degree of spondylolisthesis was different.4. there was no signigicant correlation between the degree of spondylolisthesis and the coronal angle of the L4-5 facet joint, and ages as well.5. The facet joint of displacement segment(L5-S1) of isthmic spondylolisthesis have no appearance of degeneration,and the coronal angle of the L5-S1 facet joint has no different with control group.Conclusion:There are varying degrees of degenerative changes in facet joint of patients with degenerative spondlolisthesis.the changes of lumbar facet joint morphology were results of lumber vertebra degeneration but not major etiological factor. the changes of lumbar facet joint morphology play a role in in the process of degenerative spondylolisthesis and reconstruction of stabilization.