Are facet joint parameters risk factors for recurrent lumbar disc herniation? A pilot study in a Chinese population

J Clin Neurosci. 2020 Jul:77:36-40. doi: 10.1016/j.jocn.2020.05.048. Epub 2020 May 7.

Abstract

Recurrent lumbar disc herniation (rLDH) is one of the major problems when surgically treating patients with LDH. Data on previous studies investigated the associations between facet joint parameters and rLDH appear only rarely in the literature. This study's objective was to evaluate the association between facet joint parameters [facet orientation (FO) and facet tropism (FT)] and rLDH. From June 2005 to January 2014, 346 patients having single-level lumbar disc herniation (LDH), who underwent surgery, were included in this study. We divided the patients into the recurrent group (R group) and the nonrecurrent group (N group). According to 25%, 50% and 75% quantiles of FO, all the cases were divided into 4 subgroups (<42°, 42~45°, 46~49°, and >49°). Cases were divided into 3 groups according to different range of FT (<3°, 3~4° and >4°). The relationships between the facet joint parameters and rLDH were evaluated. All cases in the study were followed up for more than 5 years postoperatively. The recurrence rates of different FO groups were statistically significant (P < 0.001). With the decrease of FO, the risk of rLDH increases continuously. Also, there were statistically significant recurrence rates in different FT groups (P < 0.001), which showed the incidence of rLDH increases gradually with the increase of FT. Facet joint parameters significantly influence the biomechanics of the corresponding segment. Facet joint parameters may play a more important role in the pathogenesis of rLDH.

Keywords: Facet orientation (FO); Facet tropism (FT); Lumbar facet joint; Recurrent lumbar disc herniation (rLDH); Risk factor.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • China / epidemiology
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Displacement / diagnosis*
  • Intervertebral Disc Displacement / epidemiology*
  • Intervertebral Disc Displacement / surgery
  • Lumbar Vertebrae / anatomy & histology*
  • Lumbar Vertebrae / surgery
  • Male
  • Middle Aged
  • Pilot Projects
  • Population Surveillance* / methods
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Young Adult
  • Zygapophyseal Joint / anatomy & histology*
  • Zygapophyseal Joint / surgery