Lumbar facet joint subchondral bone density in low back pain and asymptomatic subjects

被引:11
|
作者
Pan, Chien-Chou [1 ,2 ]
Simon, Peter [1 ,3 ]
Orias, Alejandro A. Espinoza [1 ]
Takatori, Ryota [1 ,4 ]
An, Howard S. [1 ]
Andersson, Gunnar B. J. [1 ]
Inoue, Nozomu [1 ]
机构
[1] Rush Univ, Med Ctr, Dept Orthoped Surg, 1611 W Harrison St,Suite 201 Orthoped Bldg, Chicago, IL 60612 USA
[2] Taichung Vet Gen Hosp, Dept Orthoped Surg, Taichung, Taiwan
[3] Fdn Orthopaed Res & Educ, Phillip Spiegel Orthopaed Res Lab, Tampa, FL USA
[4] Kyoto Prefectural Univ Med, Grad Sch Med Sci, Dept Orthoped, Kyoto, Japan
关键词
Lumbar facet joint; Subchondral bone density; Low back pain; IN-VIVO; LOAD TRANSMISSION; OSTEOABSORPTIOMETRY; ADAPTATION; INJURIES; PATTERNS; DISEASE; PLATE;
D O I
10.1007/s00256-019-03314-w
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objective To report in vivo measurements of lumbar facet joint subchondral bone mineral density used in the description of facet joint loading patterns and to interrogate if low back pain is associated with changes in subchondral bone mineral density. Materials and methods In vivo measurements of lumbar facet joint subchondral bone mineral density (L1/2 to L5/S1) in Hounsfield units were performed on 89 volunteers (56 controls and 33 with low back pain) by computed tomography osteoabsorptiometry at subchondral regions between 1.5 mm and 2.5 mm below the joint surface. The facet surface was divided into five topographic zones: cranial, lateral, caudal, medial, and central. Results We analyzed 1780 facet joint surfaces. Facets were denser (p < 0.0001) both in superior facets and in low back pain subjects (p < 0.0001). For the entire cohort, the facet center zone subchondral bone mineral density was higher (p < 0.0001) than that of the peripheral zones. The analyses indicate that subchondral bone mineral density is highest in patients with low back pain, the superior facets, and the center zone of the facets. Conclusions Subchondral bone mineral density is thought to reflect cumulative, long-term distribution of stress acting on a joint. This work shows that higher subchondral bone mineral density values in the center zone indicate predominant stress transmission through the center of the facet joints. Finally, the greater subchondral bone mineral density in patients with low back pain may reflect both increased load bearing by the facets secondary to disc degeneration and misdistribution of loading within the joint.
引用
收藏
页码:571 / 576
页数:6
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