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Facet joint hypertrophy is a misnomer: A retrospective study
Sang Joon An1, Mi Sook Seo, Soo Il Choi
1Department of Neurology Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary's Hospital, Incheon Department of Anesthesiology and Pain Medicine, Eulji General Hospital, Eulji University College of Medicine Department of Anesthesiology and Pain Medicine, National Police Hospital, Seoul, Republic of Korea.
Medicine
|June 15, 2018
Summary
Facet joint hypertrophy (FJH) is a misnomer for lumbar spinal canal stenosis (LSCS). New measurements show facet joints are smaller, not larger, in LSCS patients, suggesting a new name: facet joint area narrowing.
Area of Science:
- Orthopedics and Spine Surgery
- Radiology
- Anatomy
Background:
- Facet joint hypertrophy (FJH) is widely cited as a cause of lumbar spinal canal stenosis (LSCS).
- Previous research questioned whether FJH is an accurate term, suggesting it may be a misnomer.
- Empirical evidence to support or refute the misnomer hypothesis for FJH in LSCS has been lacking.
Purpose of the Study:
- To investigate whether facet joint hypertrophy (FJH) is a misnomer in patients diagnosed with lumbar spinal canal stenosis (LSCS).
- To introduce and validate new morphological parameters: facet joint thickness (FJT) and facet joint cross-sectional area (FJA).
- To provide a more accurate terminology for describing facet joint changes in LSCS.
Main Methods:
- Collected facet joint thickness (FJT) and facet joint cross-sectional area (FJA) data from 114 patients with LSCS.
- Utilized lumbar magnetic resonance imaging (MRI), specifically axial T2-weighted images, from both LSCS patients and 86 control subjects.
- Defined FJT as the narrowest point along the facet area and FJA as the total cross-sectional area at the L4-L5 level.
Main Results:
- Patients with LSCS exhibited significantly lower average FJT (1.11 ± 0.32 mm) compared to controls (1.60 ± 0.36 mm).
- LSCS patients also showed significantly lower average FJA (9.31 ± 3.47 mm²) than the control group (14.46 ± 5.17 mm²).
- Both FJT and FJA were significantly reduced in the LSCS group (P < .001), contradicting the concept of hypertrophy.
Conclusions:
- Facet joint hypertrophy (FJH) is indeed a misnomer for the condition observed in lumbar spinal canal stenosis (LSCS).
- The findings support renaming FJH to "facet joint area narrowing" for improved diagnostic clarity.
- Adopting precise terminology like "facet joint area narrowing" will reduce confusion in spinal stenosis literature.
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