INFLUENCE OF FACET TROPISM ON THE LOCATION OF LUMBAR DISC HERNIATION

ABSTRACT Objective: To correlate facet tropism with the side and location of the intervertebral disc in which the lumbar disc herniation occurred. Methods: A retrospective descriptive study that evaluated Magnetic Resonance Imaging of 255 patients with lumbar disc herniation undergoing surgical treatment with the Spine Group of the Hospital Ortopédico de Passo Fundo between 2002 and 2014. The total patient number was stratified according to the side affected by the herniated disc (right or left), location of the hernia in the intervertebral disc (central, centrolateral, foraminal and extraforaminal) and demographic data, such as age, gender etc. The degree of facet joint tropism was measured by the Karakan method and classified as mild (difference less than 7º); moderate (between 7º and 15º) and severe (difference greater than 15º). Results: A statistical significant relationship (p= 0.023) was observed between the facet joint tropism and the side where the lumbar disc herniation occurred. No correlation was found between facet joint tropism and location of the herniation on the intervertebral disc. Conclusions: The degree of facet tropism presents a statistical significant correlation with the side of the intervertebral disc in which the lumbar disc herniation will develop. Level of Evidence: II. Type of study: Retrospective study.

摘要
研究目的：探讨腰椎间盘突出症的发病侧别、椎间盘位置与关节突关节不对称（facet tropism）的相关性。
研究方法：本研究为回顾性描述性研究，纳入2002年至2014年间于帕索丰多骨科医院脊柱外科团队接受手术治疗的255例腰椎间盘突出症患者的磁共振成像（Magnetic Resonance Imaging）资料进行分析。根据突出椎间盘累及侧别（左侧或右侧）、椎间盘突出位置（中央型、中央旁型、椎间孔型及椎间孔外型）以及年龄、性别等人口统计学资料对全部患者进行分层分析。采用卡拉坎法（Karakan method）测量关节突关节不对称程度，并分为轻度（角度差＜7°）、中度（7°~15°）及重度（角度差＞15°）三个等级。
研究结果：观察发现关节突关节不对称与腰椎间盘突出症的发病侧别存在统计学意义的相关性（p=0.023）；未发现关节突关节不对称与椎间盘突出位置存在相关性。
研究结论：关节突关节不对称程度与腰椎间盘突出症的发病节段侧别存在显著统计学相关性。
证据等级：Ⅱ级。
研究类型：回顾性研究。