Acta clinica Croatica, Vol. 55. No. 1., 2016.
Original scientific paper
https://doi.org/10.20471/acc.2016.55.01.17
Facet Orientation and Tropism: Association with Accelerated Degeneration of Stabilizing Structures in Lower Lumbar Spine
Vjekoslav Jeleč
; Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia; School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia
Rajka Turner
orcid.org/0000-0003-0221-8719
; Private Practice, Zagreb, Croatia
Miljenko Franić
; Department of Orthopedics, Dubrava University Hospital, Zagreb, Croatia
Anđelko Korušić
; Clinical Department of Anesthesiology, Resuscitation and Intensive Care, Dubrava University Hospital, Zagreb, Croatia; School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia
Krešimir Rotim
; Clinical Department of Neurosurgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Abstract
The influence of facet orientation and tropism on the process of spinal degeneration has been extensively studied during the last few decades, but there are still many controversies and conflicting results in this field of research. The biomechanical cause of accelerated degeneration of stabilizing structures in lower lumbar spine lies within the combination of several factors, but two most important ones are compressive load and more coronal facet orientation that offers less
resistance against torsional loading. Axial rotation of lower lumbar spine is undoubtedly associated with higher strain in disc annulus, and enhanced range of secondary rotational movements may be even more significant for the progression of annular degeneration. Accordingly, more pronounced facet tropism could be having part in faster progression of disc degeneration in lower lumbar spine, as indicated by a number of recent studies. More sagittal facet orientation in patients with a higher facet osteoarthritis score at lower lumbar segments is very likely related to arthritic remodeling commonly seen in other synovial joints. There is also a possibility that it could be associated with the adaptation to partial loss of lumbar lordosis, as both coincide with advanced age.
Keywords
Intervertebrae disc, degeneration; Lumbar vertebrae – radigraphy; Magnetic resonance imaging; Osteoarthritis; Biomechanical phenomena
Hrčak ID:
161286
URI
Publication date:
1.3.2016.
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