Ishihara H, Matsui H, Osada R, Ohshima H, Tsuji H
Department of Orthopaedic Surgery, Toyama Medical and Pharmaceutical University, Japan.
Spine (Phila Pa 1976). 1997 Sep 1;22(17):2001-4. doi: 10.1097/00007632-199709010-00012.
This study compared the incidence of facet joint asymmetry between adult and juvenile patients with lumbar intervertebral disc herniation.
To determine the different distribution of the facet joint asymmetry between the adult and juvenile patients.
As early as 1967, it was suggested that asymmetry of the facet joints is correlated with the development of disc herniation. There have been numerous arguments for and against Farfan's hypothesis, however, most studies were carried out on adult patients, and this hypothesis has not been verified in juvenile patients.
The study group consisted of 29 levels of 25 patients aged 12-20 years (juvenile group) and 50 levels of 33 patients aged 30-49 years (adult group) who underwent posterior discectomy. The shape of facet joints, the facet joint angle, and the moment arm angle and length were measured for each facet joint using computed tomography. Facet joint asymmetry was defined as the difference in facet joint shape or a difference of more than 10 degrees in facet joint angles between the right and left sides. The incidence of facet joint asymmetry and the relationships among the facet joint asymmetry and the location, type of disc herniation, and disc degeneration were examined in juvenile and adult groups.
The overall incidence of facet joint asymmetry was significantly higher in the juvenile group (12 levels, 41%) than in the adult group (four levels, 8%; P < 0.01). There were no significant relationships among the facet joint asymmetry, the location, type of disc herniation, and disc degeneration.
This study revealed that the frequency of facet joint asymmetry in the juvenile group was five times higher than that in the adult group. This result indicates that facet joint asymmetry is a radiologic feature of lumbar intervertebral disc herniation in children and adolescents.
本研究比较了成人和青少年腰椎间盘突出症患者小关节不对称的发生率。
确定成人和青少年患者小关节不对称的不同分布情况。
早在1967年，就有人提出小关节不对称与椎间盘突出的发生有关。对于法凡假说，一直存在众多支持和反对的观点，然而，大多数研究是在成年患者中进行的，该假说尚未在青少年患者中得到验证。
研究组包括25例年龄在12 - 20岁的患者（青少年组）的29个节段，以及33例年龄在30 - 49岁的患者（成人组）的50个节段，这些患者均接受了后路椎间盘切除术。使用计算机断层扫描测量每个小关节的小关节形状、小关节角度、力臂角度和长度。小关节不对称定义为小关节形状的差异或左右两侧小关节角度相差超过10度。在青少年组和成人组中检查小关节不对称的发生率以及小关节不对称与椎间盘突出的位置、类型和椎间盘退变之间的关系。
青少年组小关节不对称的总体发生率（12个节段，41%）显著高于成人组（4个节段，8%；P < 0.01）。小关节不对称与椎间盘突出的位置、类型和椎间盘退变之间无显著关系。
本研究表明，青少年组小关节不对称的频率比成人组高五倍。这一结果表明，小关节不对称是儿童和青少年腰椎间盘突出症的一种影像学特征。
