The hidden asymmetry: facet joint tropism as a clue to spinal malalignment and muscle degeneration in adult spinal deformity.

IF 1.6 Q3 CLINICAL NEUROLOGY

Spine deformity Pub Date : 2025-06-19 DOI:10.1007/s43390-025-01133-9

Ganesh Kumar, Alex T Johnson, Archit Goyal, Vikas Tandon, Rajat Mahajan, Bibhudendu Mohapatra, Kalidutta Das

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引用次数: 0

Abstract

Objectives: The role of facet joint tropism (FJT) in degenerative spinal disorders such as disc herniation, spondylolisthesis, and lumbar canal stenosis is well-established. However, its association with adult spinal deformity (ASD) remains underexplored. Hence, we aim to study the correlation of FJT with spinopelvic parameters and lumbar paraspinal muscle morphology in ASD patients.

Materials and methods: We analysed 117 patients with ASD from 2021 to 2024. An absolute value difference (ΔFJA) of more than 10 degrees between the right- and left-facet joint angle (FJA) was defined as FJT. We considered patients with FJT at the apex vertebra as the FJT + group and with ASD but without FJT as the FJT- group.

Results: The mean ΔFJAs between the FJT + (n = 45) and FJT- (n = 45) were 17.14 and 5.38, respectively. For Cobb angle (CA) > 40˚ (n = 13), 84.6% (n = 11) belonged to the FJT + group. For CA 10-19˚(n = 28), 78.6% (n = 22) belonged to the FJT- group. Of the radiological parameters, differences in CA (p = 0.012), pelvic incidence (PI) (p = 0.031), grades of vertebral body rotation (VBR) (p = 0.022), facet joint osteoarthritis grades (FJOA) (p = 0.040) and cross-sectional area (CSA) of concave multifidus muscle (MF) (p = 0.010) were statistically significant between both the groups. The CSA of MF was decreased on the concave side (2.45 cm²) compared to the convex side (3.70 cm²) and was negatively correlated with ΔFJA (R² = 0.642, p = 0.020). The ΔFJA had significant positive correlation with CA (R² = 0.550, p = 0.010), PI (R² = 0.624, p = 0.030), grades of VBR (R² = 0.610, p = 0.007), and grades of FJOA (R² = 0.780, p = 0.005).

Conclusions: Patients with ASD and FJT exhibited greater Cobb angle, higher PI, higher grades of FJOA and VBR, and lower CSA of concave MF. However, the role of facet joint tropism in adult spinal deformity-whether causal or compensatory-warrants validation through longitudinal, long-term studies.

Level of evidence: Level III.

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隐藏的不对称：小关节向性是成人脊柱畸形中脊柱错位和肌肉退变的线索。

目的：小关节向性（FJT）在椎间盘突出、腰椎滑脱和腰椎管狭窄等退行性脊柱疾病中的作用已得到证实。然而，其与成人脊柱畸形（ASD）的关系仍未得到充分研究。因此，我们的目的是研究FJT与ASD患者脊柱参数和腰椎棘旁肌形态的相关性。材料和方法：我们分析了2021年至2024年117例ASD患者。当左右关节突关节角（FJA）绝对值差值（ΔFJA）大于10度时，定义为FJT。我们将顶端椎体有FJT的患者视为FJT +组，将ASD但无FJT的患者视为FJT-组。结果：FJT +组（n = 45）和FJT-组（n = 45）的平均ΔFJAs分别为17.14和5.38。Cobb角(CA) > 40˚（n = 13）， 84.6% （n = 11）属于FJT +组。CA 10-19˚（n = 28）中，78.6% （n = 22）属于FJT-组。影像学指标中，两组间CA （p = 0.012）、骨盆发生率（PI）（p = 0.031）、椎体旋转分级（VBR）（p = 0.022）、小关节骨性关节炎分级（FJOA）（p = 0.040）、凹多裂肌（MF）横截面积（CSA）（p = 0.010）差异均有统计学意义。MF的凹侧CSA （2.45 cm2）低于凸侧（3.70 cm2），且与ΔFJA呈负相关（R2 = 0.642, p = 0.020）。ΔFJA与CA （R2 = 0.550, p = 0.010）、PI （R2 = 0.624, p = 0.030）、VBR分级（R2 = 0.610, p = 0.007）、FJOA分级（R2 = 0.780, p = 0.005）呈显著正相关。结论：ASD合并FJT患者Cobb角较大，PI较高，FJOA和VBR分级较高，凹MF的CSA较低。然而，小关节向性在成人脊柱畸形中的作用——无论是因果性还是代偿性——需要通过纵向、长期的研究来验证。证据等级：三级。

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

Spine deformity

CiteScore

3.20

自引率

18.80%

发文量

167

期刊介绍： Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.