Acta Ortopédica Mexicana

Pimenta L, Bellera AF, León PM, Díaz ORC
Radiographic classification of the lumbar facet degeneration: Intra and interobserver evaluation
Acta Ortop Mex 2005; 19 (3)

Language: Español
References: 25
Page: 95-98
PDF: 66.59 Kb.

[Fulltext - PDF]

ABSTRACT

Although the facet pathology, is a clear entity, there are not well defined diagnostic criteria. The orthopedic classifications are created in order to have a general agreement for the prognosis and treatment of a specific disease. Purpose. Establish a classification for the lumbar facet degeneration and analyzed it using a statistical analysis to obtain the intraobserver and interobserver reliability. Material and methods. Twenty-five MRI images of the lumbar spine were evaluated by twelve surgeons. In order to evaluate the intraobserver reliability, a comparison between two viewing for the same surgeon is presented. For the interobserver reliability, an agreement percentage for each grade and the kappa coefficient were calculated. Results. There was an intraobserver and interobserver agreement in 90% and 87.7% respectively. The mean kappa coefficient was 0.74. Discussion. A classification is a pre requisite to the definition of a specific treatment, and for this purpose a degenerative lumbar facet classification is presented.


Key words: osteoarthritis, facet joint, retrograde degeneration, radiography.


REFERENCES

  1. Igarashi A, Kikuchi S, Konno S: Inflammatory cytokines released from the facet joint tissue in degenerative lumbar spinal disorders. Spine 2004; 29(19): 2091-2095.

  2. Lewinnek G, Warfield C: Facet joint degeneration as a cause of low back pain. Clin Orthop 1986; 214: 216-222.

  3. Mooney V, Robertson J: The facet syndrome. Clin Orthop 1976; 115: 149-156.

  4. Dupont P, Lavaste F, Skalli W: The role of disc, facets and fibres in degenerative process: a sensitivity study. Stud Health Technol Inform 2002; 88: 356-359.

  5. Gries N, Belemann U, Moore R: Early histologic changes in lower lumbar discs and facet joints and their correlation. Eur Spine J 2000; 9(1): 23-29.

  6. Suseki K, Takahshi Y, Takashashi K: Innervation of the lumbar facet joints: origins and functions. Spine 1997; 22(5): 477-485.

  7. Adams M, Hutton W: The mechanical function of the lumbar apophyseal joints. Spine 1983; 8(3): 327-330.

  8. Cavanaugh J, Ozaktay A, Yamashita H: Lumbar facet pain: biomechanics, neuroanatomy and neurophysiology. Biomech 1996; 29(9): 1117-1129.

  9. Yang K, King A: Mechanism of facet load transmission as a hypothesis for low-back pain. Spine 1984; 9(6): 557-565.

  10. Carrera G, Williams A: Current concepts in evaluation of the lumbar facet joints. Crit Rev Diagn Imaging 1984; 21(2): 85-104.

  11. Lilius G, Laasonen E, Myllynen P: Lumbar facet joint syndrome. A randomized clinical trial. J Bone Joint Surg Br 1989; 71(4): 681-684.

  12. Chen T: The controversy over diagnosis and treatment of facet pain. J Chin Med Assoc 2005; 68(2): 51-52.

  13. Schwarzer A, Wang S, O’Driscoll D: The ability of computed tomography to identify a painful zygapophysial joint in patients with chronic low back pain. Spine 1995; 20(8): 907-912.

  14. Dunlop R, Adams M, Hutton W: Disc space narrowing and the lumbar facet joints. J Bone Joint Surg Br 1984; 66(5): 706-710.

  15. Helbig T, Lee C: The lumbar facet syndrome. Spine 1988; 13(1): 61-64.

  16. Schwarzer A, Aprill C, Derby R: Clinical features of patients with pain stemming from the lumbar zygapophysial joints. Is the lumbar facet syndrome a clinical entity? Spine 1994; 19(10): 1132-1137.

  17. Revel M, Listrat V, Chevalier X: Facet joint block for low back pain: identifying predictors of a good response. Arch Phys Med Rehabil 1992; 73(9): 824-828.

  18. Schellinger D, Wener L, Ragsdale B, Patronas N: Facet joint disorders and their role in the production of back pain and sciatica. Radiographics 1987; 7(5): 923-944.

  19. Elsenstein S, Parry C: The lumbar facet arthrosis syndrome. Clinical presentation and articular surface changes. J Bone Joint Surg Br 1987; 69(1): 3-7.

  20. Fujiwara A, Tamai K, Kurihashi T: The relationship between disc degeneration, facet joint osteoarthritis, and stability of the degenerative lumbar spine. J Spinal Disord 2000; 13(5): 444-450.

  21. Weishaupt D, Zanneti M, Boos N: MR imaging and CT in osteoarthritis of the lumbar facet joints. Skeletal Radiol 1999; 28(4): 215-219.

  22. Greher M, Kirchmair L, Enna B: Ultrasound-guided lumbar facet nerve block: accuracy of a new technique confirmed by computed tomography. Anesthesiology 2004; 101(5): 1195-1200.

  23. Shih C, Lin G, Yueh K: Lumbar zygapophyseal joint injections in patients with chronic lower back pain. J Chin Med Assoc 2005; 68(2): 59-64.

  24. Zander T, Rolhman A, Klockner C: Influence of graded facetectomy and laminectomy on spinal biomechanics. Eur Spine J 2003; 12(4): 427-434.

  25. Landis J: The measurement of observer agreement for categorical data. Biometrics 1977; 33(1): 159-174.