Kulkarni Arvind G, Sagane Shrikant S
Department of Orthopaedics, Mumbai Spine Scoliosis and Disc Replacement Centre, Bombay Hospital and Medical Research Center, Mumbai, Maharashtra, India.
J Craniovertebr Junction Spine. 2022 Jan-Mar;13(1):38-41. doi: 10.4103/jcvjs.jcvjs_155_21. Epub 2022 Mar 9.
The aim of this study was to trace the association between cervical facet joint effusion and cervical degenerative spondylolisthesis (CDS). CDS has not received as much attention as its lumbar counterpart. Identification of features of instability on magnetic resonance imaging (MRI) is crucial to avoid missing presence of CDS.
The authors retrospectively reviewed cervical spine MRI scans and upright lateral flexion-extension radiographs of 17 consecutive patients at a single institution between January 2017 and June 2018 that revealed CDS. Presence of cervical facet joint effusion and CDS was recorded. Data were analyzed to deduce possibility of an association between cervical facet joint effusion and CDS.
Seventeen patients fulfilled the inclusion criteria of cervical spondylotic myelopathy associated with CDS. Out of these, 10 patients revealed facet joint effusion at C3-C4 (4 patients) and C4-C5 (6 patients) levels. The mean age of patients was 65.8 years (49-79) and M:F was 2.2:1. Amount of facet joint effusion varied and ranged from 1.6 mm to 4.7 mm on the axial images. Ten patients (58.82%) demonstrated facet joint effusion associated with mobile CDS. Seven patients (41.17%) with CDS and without facet effusion did not demonstrate mobility of more than 0.5 mm in flexion-extension radiographs.
The current study acknowledges the association of "cervical facet effusion" and CDS. Clinically measurable facet joint effusion on MRI suggests the need for further attempts to diagnose CDS.
本研究旨在追踪颈椎小关节积液与颈椎退变性椎体滑脱(CDS)之间的关联。CDS并未像腰椎退变性椎体滑脱那样受到同等程度的关注。在磁共振成像(MRI)上识别不稳定特征对于避免漏诊CDS至关重要。
作者回顾性分析了2017年1月至2018年6月间在单一机构连续17例经MRI检查显示患有CDS的患者的颈椎MRI扫描图像及站立位颈椎侧屈-后伸X线片。记录颈椎小关节积液及CDS的存在情况。对数据进行分析以推断颈椎小关节积液与CDS之间存在关联的可能性。
17例患者符合与CDS相关的脊髓型颈椎病的纳入标准。其中,10例患者在C3 - C4(4例)和C4 - C5(6例)水平显示有小关节积液。患者的平均年龄为65.8岁(49 - 79岁),男性与女性比例为2.2:1。在轴位图像上,小关节积液量各不相同,范围为1.6毫米至4.7毫米。10例患者(58.82%)显示小关节积液与活动型CDS相关。7例患有CDS但无小关节积液的患者在侧屈-后伸X线片上显示活动度不超过0.5毫米。
本研究证实了“颈椎小关节积液”与CDS之间的关联。MRI上可临床测量的小关节积液提示有必要进一步尝试诊断CDS。