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2014년 2월 22일 토요일

Asymmetric Facet Joint Osteoarthritis and its Relationships to Facet Orientation, Facet Tropism and Ligamentum Flavum Thickening

Brief review

이 논문은 작년 11월에 나온 논문인데, 얼마전에 포스팅한 논문에 나와있던 facet joint osteoarthritis-4 grade를 인용한 논문 입니다. 연구목적은 관절염에 의해 비대칭된 후관절과 후관절의 방향, 비대칭, 황색인대의 비대 와의 관련성을 밝히는 것 입니다.

후관절의 대칭정도에 따라 연구대상을 비대칭그룹과 대칭 그룹으로 나누었습니다.
대칭그룹은 후관절 양쪽의 osteoarthritis 모두 grade1 or 2 거나 혹은 모두 grade3 or 4 이며, 비대칭그룹은 한쪽이 grade1 or 2이고, 나머지 한쪽이 grade3 or 4 인 환자가 포함되었습니다
후관절의 orientation, tropism Ligamentum Flavum Thickness는 모두 CT image를 측정했습니다.

결론적으로, 비대칭 후관절의 관절염은 facet orietation, tropism과 연관성이 있지만 요추레벨과는 관련이 없었습니다. 그리고 후관절의 관절염과 Ligamentum Flavumthickness와는 밀접한 관련이 있었습니다.

아래 bibliography에 해당저널 링크 걸어두었으니 읽어보세요:)


*Title: Asymmetric Facet Joint Osteoarthritis and its Relationships to Facet Orientation, Facet Tropism and Ligamentum Flavum Thickening.
비대칭 후관절의 관절염과 후관절의 방향, 비대칭, 황색인대의 비대 와의 관련성

*Authors: Liu HX, Shen Y, Shang P, Ma YX, Cheng XJ, Xu HZ.



STUDY DESIGN
The degrees of osteoarthritis of the left and right facet joints were evaluated by using CT among elderly patients with low back or leg pain.


OBJECTIVE
To reveal the phenomenon of asymmetry regarding facet joint osteoarthritis (FJOA) in old patients.
To establish its relationships to spinal level, facet orientation, facet tropism and ligamentum flavum (LF) thickening.


SUMMARY OF BACKGROUND DATA
There were few reports regarding left-right asymmetry among severity of FJOA and its relationships to spinal level, facet orientation, facet tropism and LF thickening remained unclear.


METHODS
Evaluating method: FJOA was evaluated using 4-grade scale (L3-4, L4-5, L5-S1)

All subjects were divided into two groups:
1) symmetric FJOA group: (FJOA I-II on both sides or FJOA III-IV on both sides)
2) asymmetric FJOA group: (FJOA I-II on one side and FJOA III-IV on the other side).
-facet joint osteoarthritis 4개의 grade 나눈 figure 참고(Kalichman et al)


























-The relationships of FJOA to spinal level, facet orientation, facet tropism, and LF hypertrophy were evaluated.


RESULTS
Spinal level: -No association with asymmetric FJOA.
Facet orientation: significantly associated with facet orientation at the L4-5, L5-S1.
Facet tropism: significant prevalence in asymmetric FJOA > symmetric FJOA (L5-S1).
Ligamentum flavum: significantly thicker FJOA III-IV > FJOA I-II (in asymmetric FJOA group)
(no difference in thickness in symmetric FJOA group)


CONCLUSIONS
-Asymmetric FJOA is associated with facet orientation and tropism, but not with spinal level.
-There is a close relationship between severity of FJOA and LF thickness.