Department of Orthopedics (Spine Surgery), the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China.
Spine (Phila Pa 1976). 2021 Mar 1;46(5):E310-E317. doi: 10.1097/BRS.0000000000003788.
A retrospective case-control study.
Investigating the correlation between the facet tropism (FT) and subaxial cervical disc herniation (CDH).
Although debatable, it was widely reported that FT was associated with lumbar disc herniation. However, the exact correlation between FT and subaxial CDH is still unclear.
Two-hundred patients with any disc herniation at C3/4, C4/5, C5/6, or C6/7 and 50 normal participants without CDH (normal control group) were included in this study. For patients, the cervical levels with CDH and the levels without herniation were classified into the "herniation group" and "patient control group," respectively. Bilateral facet joint angles at C3/4, C4/5, C5/6, and C6/7 on sagittal, axial, and coronal planes were measured on computed tomography (CT). The disc degeneration at each level was assessed on magnetic resonance imaging (MRI).
Both the mean difference between left and right facet angles and tropism incidence in herniation group were significantly greater than those in two control groups whenever at C3/4, C4/5, C5/6, or C6/7 level and whenever on sagittal, axial, or coronal plane. The mean differences of angles and tropism incidences in most patient control groups were not significantly greater than those of corresponding normal control groups. The incidence of greater facet angle at the left or right side was not significantly different among the left, central, and right herniation groups. The mean disc degeneration grades in both herniation and patient control groups were significantly higher than those in normal control groups while no difference between herniation and patient control groups.
The FT on the sagittal, axial, and coronal planes are all associated with CDH in the subaxial cervical spine. The greater facet angle at the left or right side does not affect the side of herniation. The severity of cervical disc degeneration is not associated with FT.Level of Evidence: 3.
回顾性病例对照研究。
研究小关节突倾斜（FT）与下颈椎间盘突出症（CDH）之间的相关性。
虽然存在争议，但广泛报道称 FT 与腰椎间盘突出症有关。然而，FT 与下颈椎 CDH 的确切相关性尚不清楚。
本研究纳入了 200 例 C3/4、C4/5、C5/6 或 C6/7 节段有椎间盘突出症的患者和 50 例无 CDH 的正常参与者（正常对照组）。对于患者，将有 CDH 的颈椎水平和无突出的水平分别归类为“突出组”和“患者对照组”。在矢状位、轴位和冠状位上，通过计算机断层扫描（CT）测量 C3/4、C4/5、C5/6 和 C6/7 双侧小关节角度。在每个节段上，通过磁共振成像（MRI）评估椎间盘退变程度。
无论在 C3/4、C4/5、C5/6 还是 C6/7 水平，无论在矢状位、轴位还是冠状位上，突出组的左右小关节角度的平均差值和倾斜发生率均显著大于两个对照组。在大多数患者对照组中，角度和倾斜发生率的平均差值并不显著大于相应的正常对照组。左侧、中央和右侧突出组左侧或右侧较大小关节角度的发生率没有显著差异。突出组和患者对照组的椎间盘退变程度均显著高于正常对照组，而突出组和患者对照组之间无差异。
在矢状位、轴位和冠状位上，FT 均与下颈椎的 CDH 相关。左侧或右侧较大的小关节角度并不影响突出的侧别。颈椎间盘退变的严重程度与 FT 无关。
3 级。
