Introduction
AS the only synovial joint of the spine[1], facet joint plays a significant role in maintaining the stability of the spine for resistance to shear and rotational forces[2] and bearing 33% of the dynamic load and 35% of the static load of the spine as biomechanical studies have pointed out[3] .Therefore, guiding and restricting the motion of the spine is the main function of facet joint. Some features of facet joints such as sagittal facet joint angles(FJA)and tropism (the asymmetries of facet joint) have been reported in previous literature being associated with the occurrence of degenerative lumbar spondylolisthesis(DLS) [4,5]、degenerative disc disease(DDD) [6,7]、facet joint osteoarthritis[8]
So far, many articles have pointed
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According to Grobler etl[5], selected a cut level of CT through the superior vertebral end-plate of the lower vertebra and parallel to the inferior vertebral end-plate of the superior vertebra , then three lines (line a,b,c)were marked ,among them, line a is the tangent through trailing edge of the vertebral body and line a,b through anteromedial and posterolateral point of the corresponding facet joint respectively. Angle ab and angle ac(Figure 1) as the corresponding facet joint angle were recoded.
Tropism
The definition of tropism is first proposed by Brailsford JF[12] .It refers to the asymmetry of bilateral facet joint, the absolute value of the angle difference of bilateral articular facet joint as the tropism quantitative value
Pfirrmann grading Intervertebral disc was classified into gradeⅠ- Ⅴ (图2) by Pfirrmann et al [13] based on image of sagittal MRI T2-weighted images(图3)
The angle of the facet joint was measured by two independent individuals. If the difference between the two data does not exceed 2 degrees, the average of the two measurements is taken as the angle of the corresponding facet joint. If, on the contrary, the two measured values differ by more than 2 degrees, repeat the measurement until the standard is
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Etiology of Spondylolisthesis: Assessment of the Role Played by Lumbar Facet Joint Morphology[J]. Spine, 1993, 18(1): 80-91.
[6]Karacan I, Aydin T, Sahin Z, et al. Facet angles in lumbar disc herniation: their relation to anthropometric features[J]. Spine, 2004, 29(10): 1132-1136.
[7]Witchate Pichaisak M D, Chotiyarnwong C, Pojchong Chotiyarnwong M D. Facet Joint Orientation and Tropism in Lumbar Degenerative Disc Disease and Spondylolisthesis[J]. J Med Assoc Thai, 2015, 98(4): 373-9.
[8] Linov L, Klindukhov A, Li L, et al. Lumbar facet joint orientation and osteoarthritis: a cross-sectional study[J]. Journal of back and musculoskeletal rehabilitation, 2013, 26(4): 421-426.
[9]DeVine J G, Schenk-Kisser J M, Skelly A C. Risk factors for degenerative spondylolisthesis: a systematic review[J]. Evidence-based spine-care journal, 2012, 3(02): 25-34.
[10]Schleich C, Müller-Lutz A, Blum K, et al. Facet tropism and facet joint orientation: risk factors for the development of early biochemical alterations of lumbar intervertebral discs[J]. Osteoarthritis and Cartilage, 2016.
[11]Kong M H, He W, Tsai Y D, et al. Relationship of facet tropism with degeneration and stability of functional spinal unit[J]. Yonsei medical journal, 2009, 50(5):
An MRI was performed of the lumbar spine. The examination found no significant extra
DOI: 4/16/2012. Patient is a 29-year-old male technician who sustained injury when he was 25-feet up on a ladder when the ladder slid and he fell onto the pavement. He had an open reduction internal fixation (ORIF x 2) for a compound tibia fibula fracture and had hardware removal in 4/25/2013. MRI of the lumbar spine performed on 3/24/2016 revealed L5-S1 small right paracentral disc protrusion without significant spinal canal stenosis or neuroforaminal narrowing.
This is a 47-year-old male with a 2/1/2007 date of injury, who injured his low back from lifting a large bucket of cut grass. DIAGNOSIS: 1. Left SI radicular symptoms. Lumbar discogenic pain with high-intensity zone at L5-S1 per MRI April 2007. X-ray showed 4-mm retrolisthesis at L5-S 1.
QEP Scripts for Two Recordings – Audio for Musculoskeletal System; “OK, Team! We have a new patient in Room 3B who is being admitted with a progressive (gradual, advancing) decrease in mobility (movement) of his back and legs, and increase in pain located in the lumbosacral (lower back above the tailbone of the spine) area. The patient’s Primary Care Provider has sent along Computed Tomography scans (CT, a rotating x-ray emitter, detailed internal scanner) showing spinal stenosis (narrowing of the spine causing pressure on the nerves and spinal cord causing lower back pain.) and decrease of the normal lordosis (abnormal curvature lower spine, excessive inward curvature of the spine) in the thoracic vertebrae (upper and middle back). Lumbosacral
Sacroiliac joint dysfunction is found in 15 to 30% individuals with low back pain.1 Sacroiliac joint dysfunction can be a result of acute trauma, heavy lifting, prolonged bending, torsional strain, fall on to the buttocks and motor vehicle accidents. Chronic and repetitive shear or torsional forces associated with sports like golf, bowling, skating may also result in sacroiliac joint dysfunction. Prolonged sitting or lying on the affected side, more weight bearing on the affected side during walking or standing, forward bending with knees extended may also predispose a person to sacroiliac joint dysfunction.3 Mechanism of dysfunction: Dysfunction occurs mostly when a person lifts something in a forward flexed position or stands in lordotic posture. Due to this, line of gravity shifts anterior to the acetabulum which creates rotational force in extension around
The groups were not significantly different as the t-values from both groups were 0.0526 and 0.055. Also, the p values of the lumbar and femur neck were .958 and .956
He has an antalgic gait in lumbar flexion. Mr. Danes has reduced active range of motion of the lumbar spine, especially in 5 degrees of extension which reproduces his leg pain. The following orthopedic tests were positive: Minor 's’ sign, Kemp 's on the right, Yeoman 's’ bilateral, and Milgram
DOI: 3/1/2005. Patient is a 64-year-old female service representative who sustained a work-related injury to her neck, back and bilateral shoulders due to repetitive work activities. She is subsequently diagnosed with degenerative disc disease and depression. As per progress report dated 1/14/2016, IW reports continued improvement.
It was noted that since the last evaluation, the IW notes subjective worsening of his neck, middle-back and low back pain and he demonstrates a 15 degree deterioration in cervical flexion, 10 degree deterioration in cervical extension, 10 degree deterioration in cervical rotation bilaterally, 15 degree deterioration in lumbar flexion, and 5 degree deterioration in lumbar extension. With resumption of a regular physical therapy program, short term goals include subjective decrease in his neck pain, middle-back pain, and low back pain as well as objective improvement in cervical and lumbar range of motion of 5-10 degrees, as well as improvement in his ability to perform his functional activities. Long term goals include a return to his prior level of function as well as safely perform all activities of daily living. Assessments include multiple cervical spine disc bulges and disc herniations, multiple lumbar spine disc bulges and disc herniation and thoracic spine
The spinal cord is one of the most important weight bearing structures within the body. It is comprised of four regions: the cervical, thoracic, lumbar, and sacral segments. Each region has a normal curvature that helps balance and absorb the weight of the body. However, when a curvature becomes over exaggerated, it may lead to spinal abnormalities, such as Kyphosis. Kyphosis is the forward rounding or curvature of the thoracic region of the back, which causes the formation of a hump.
When back posture goes awry this condition gets worse and causes inflammatory back pain it is referred to as Ankylosing Spondylitis. Ankylosing Spondylitis is an inflammatory auto-immune disease that can cause some or all of the spinal region to fuse together. The spine loses flexibility and the end result is a hunched posture or stance. A patient first must understand the spine and pelvic region before analyzing the severity of their condition.
The acromion is a bony process that extends laterally from the spine of the scapula (Drake, Vogl and Mitchell, 2015). This acromioclavicular joint is described as a diarthrodial synovial joint encased by a thin joint capsule lined with synovium (Alice, Jonelle, Petscavage-Thomas and Gino, 2014). The joint is stabilised by three ligaments. Ligaments are strong bands of inelastic fibrous tissue that connect bone to bone and enhance the stability of a joint (Dudley, 2006).The outer third of the clavicle is joined to the scapula by the conoid and trapezoid ligaments of the coracoclavicular ligament and superiorly the acromioclavicular ligament passes between adjacent regions of the clavicle and acromion [1] (Drake, Vogl and Mitchell, 2015). As well as this the joint is also reinforced by the fascial attachments of the overlying deltoid and trapezius muscles (Greene and Karas, 2010).
On examination of the lumbar spine, it appears straightened with a 30% decrease in range of motion. There is tenderness to palpation bilaterally at L3 through S1 paraspinal muscles facet joint. Extension, lateral bending and rotation causes more pain. Straight leg raise testing is positive bilaterally, more on the right side, at 50 degrees. Sensation is decreased to light touch and pinprick at L5
First, Physical therapists make an observation, which is the observing phase of examination of the patient’s condition. Once they do this process of examination, they can have an idea about if the patients have severe problems such as abnormal curvature of spine or joint subluxation, which according to introduction to physical therapy, joint subluxation is “(a condition in which a joint partially dislocates)”. In addition, in the phase of examination there are observed many musculoskeletal injuries, which are disorders that affect the human body’s movement or musculoskeletal system such as, muscles, tendons, ligaments, and nerves. Therefore specific attention is paid to the standing and sitting postures of the patient. Equally important, parts
BACKGROUND AND LITERATURE REVIEW 2. Clinical Background 2.1 The human spine The human spine (also referred to as vertebral column or spinal column) is a bony structure in the middle of the back starts at the base of the skull and continues to the pelvis. It consists of vertebrae (small bones) and joints (intervertebral disks) together to form a flexible and stable spinal column.