Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Department of Radiodiagnosis, VMMC and Safdarjung Hospital, New Delhi, India.
World Neurosurg. 2021 Mar;147:47-65. doi: 10.1016/j.wneu.2020.11.171. Epub 2020 Dec 9.
Facet tropism (FT) refers to the difference in the orientation of facet joints with respect to each other in the sagittal plane. FT leads to unequal biomechanical forces on facet joint and intervertebral disc during rotation and other physiologic movements. Most of the studies have reported the incidence of FT in the lumbar spine to vary between 40% and 70%, with L4-5 level being the most commonly afflicted level. The objective of this study was to find the association between FT and various lumbar and cervical degenerative disorders.
A systematic search of PubMed was performed with the keywords "facet tropism" and "facet asymmetry." Data for meta-analysis were extracted from the studies to obtain pooled impact of FT on lumbar disc herniation (LDH) and lumbar degenerative spondylolisthesis (LDS).
Eighty-two articles were included in the systematic review and 18 studies had the required data to be included in the meta-analysis. The pooled standard mean difference between FT angles in patients with or without LDH was 0.31 with (P = 0.04). The pooled odds ratio for FT in patients with LDH was 3.27 with (P = 0.02). Subgroup analysis showed that there is no significant difference in the L3/4, L4/5, and L5S1 subgroups. The pooled standard mean difference between FT angles in patients with or without LDS was 0.54 (P = 0.009).
FT is significantly associated with LDH and LDS along with various other lumbar and cervical degenerative diseases.
小关节偏斜（FT）是指小关节在矢状面上彼此之间的方向差异。FT 导致在旋转和其他生理运动期间小关节和椎间盘上的生物力学力不均匀。大多数研究报告称，腰椎的 FT 发生率在 40%至 70%之间，其中 L4-5 水平是最常受累的水平。本研究的目的是确定 FT 与各种腰椎和颈椎退行性疾病之间的关联。
使用关键词“小关节偏斜”和“小关节不对称”对 PubMed 进行系统搜索。从研究中提取数据进行荟萃分析，以获得 FT 对腰椎间盘突出症（LDH）和腰椎退行性滑脱（LDS）的综合影响。
系统评价共纳入 82 篇文章，18 项研究有符合纳入标准的必要数据。在 LDH 患者中，FT 角度的合并标准均数差为 0.31（P=0.04）。在 LDH 患者中，FT 的合并优势比为 3.27（P=0.02）。亚组分析显示，在 L3/4、L4/5 和 L5S1 亚组中无显著差异。在 LDS 患者中，FT 角度的合并标准均数差为 0.54（P=0.009）。
FT 与 LDH 和 LDS 以及其他各种腰椎和颈椎退行性疾病显著相关。
