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Chiropractic Research Review

Disc Degeneration and Facet Joint Osteoarthritis

Degenerative disc disease (DD) is one of the major causes of back symptoms. It is believed to be associated with segmental instability of the spine. Frequently, DD is accompanied by facet joint osteoarthrosis (OA), although no studies have clarified how facet joint OA affects the segmental motion of the lumber spine.

The effect of spinal degeneration on segmental motion characteristics may be different in male and female spines because degenerative processes, particularly osteoarthritic changes in the facet joints, can be different between genders.

This study evaluated the relationship of DD and facet joint OA with segmental motion characteristics, including potential differences between genders. A total of 110 lumbar motion segments (52 female, 58 male) from 44 cadaveric human lumbar spines were studied (mean age; 69 years). The motion units were scanned by magnetic resonance imaging to assess the DD and OA in the facet joints. The severity of cartilage degeneration, subchondral sclerosis, osteophytes and facet joint orientation and width were assessed for OA; disc height, endplate size, and status of disc degeneration were established for DD. Rotational movements of the motion segment in response to the flexion, extension, lateral bending, and axial rotational movements were measured using a three-dimensional motion analysis system.

Results: The female spinal segments showed more motion than male spinal segments. The pattern of segmental motion changes with DD was similar between genders; greater DD led to greater segmental mobility, except DD that was rated as being the most severe. These findings support the three stages of spinal degeneration concept proposed by Kirkaldy-Willis: dysfunction, instability, and stabilization. Facet joint OA had variable effects on segmental motion, and the pattern of motion change was slightly different in male and female segments.
Results of this study suggest that axial rotation is most affected by disc degeneration. Further studies are needed to clarify whether the progression of facet joint OA differs between genders, and how facet joint OA affects the stability of the spinal motion segment.

Fujiwara A, Lim T, An HS, et al. The effect of disc generation and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine 2000:25(23), pp 3036-3044.

Chiropractic Research Review

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