Correlation Between Calcification of Facet Joint Capsule and Dynamic Instability in Lumbar Degenerative Spondylolisthesis

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-06-06 DOI:10.1016/j.wneu.2025.124163

Byung-Jou Lee , Hae-Won Koo , Seonghoon Jeong , Kwang Hyeon Kim

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Abstract

Background

To evaluate the association between facet joint capsule calcification (FCC) on computed tomography and dynamic instability on weight-bearing flexion-extension lateral X-ray in patients with degenerative spondylolisthesis at L4-5.

Methods

Clinical and radiologic data from 388 patients with degenerative spondylolisthesis who underwent lumbar magnetic resonance imaging, computed tomography, and dynamic X-ray within a 1-month interval from January 2012 to December 2021 were reviewed in this study. Radiologic factors associated with dynamic instability were evaluated: FCC, facet degeneration grade, facet joint fluid, facet tropism, disc degeneration grade, traction spur, and vacuum phenomenon. We evaluated the association between FCC and dynamic instability and determined the best cutoff value of cross-sectional area (CSA) of FCC for predicting dynamic instability.

Results

The FCC, facet joint degeneration, disc degeneration grade, and traction spur were significantly correlated with dynamic instability. The optimal cutoff point of the average CSA of FCC was measured at 14.46 mm2 with 82.3% and 96.0% sensitivity and specificity, respectively, with an area under the curve of 0.950. In the distribution in CSA of FCC according to grade of facet joint degeneration, the best cutoff value of CSA of FCC related to dynamic instability, 14.46 mm², is almost the same as the mean value of CSA of FCC for grade 2 of facet joint degeneration.

Conclusions

FCC is significantly correlated with dynamic instability in degenerative spondylolisthesis at L4-5. FCC is a radiologic finding that can be helpful in detecting dynamic instability together with dynamic X-ray.

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腰椎退行性滑脱中关节突关节囊钙化与动力不稳定的关系。

背景：评估L4-5退行性椎体滑脱患者关节突关节囊钙化（FCC）与负重屈伸侧位x线动态不稳定性之间的关系。方法：本研究回顾了388例退行性腰椎滑脱患者的临床和放射学资料，这些患者在2012年1月至2021年12月的1个月内接受了腰椎磁共振成像、CT和动态x线检查，评估了与动态不稳定相关的放射学因素；关节突囊钙化，关节突退变程度，关节突积液，关节突向性，椎间盘退变程度，牵引骨刺，真空现象。我们评估了FCC与动力失稳之间的关系，确定了FCC横截面积（CSA）预测动力失稳的最佳截断值。结果：FCC、关节突关节退变、椎间盘退变程度、牵引骨刺与动态不稳定性显著相关。FCC平均CSA的最佳截断点为14.46 mm2，灵敏度和特异度分别为82.3%和96.0%，曲线下面积（AUC）为0.950。在FCC按小关节退变等级的CSA分布中，FCC与动态失稳相关的CSA最佳截断值为14.46mm2，与FCC在小关节退变2级时的CSA均值基本一致。结论：FCC与L4-5退行性椎体滑脱的动力不稳定性显著相关。FCC是一种放射学发现，可以与动态x射线一起帮助检测动态不稳定性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS