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MRI T2-mapping of lumbar facet joints is effective for quantitative evaluation of lumbar instability in patients with degenerative lumbar disorders

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Abstract

Purposes

To analyze T2 relaxation times of the facet joint by MRI T2-mapping in patients with degenerative lumbar disorders (DLD), and to determine the correlation with lumbar instability in radiographs.

Methods

We conducted a T2-mapping of the lumbar facet joint using a 1.5 T MRI system. We classified patients with degenerative lumbar disorders scheduled to undergo decompression surgery into groups with stability and instability using radiographs, and compared the T2 relaxation times of the lumbar facet. Lumbar instability was defined as the presence of anterior translation ratio > 5% or disk range of motion (ROM) > 5° in the sagittal plane of SLFE radiographs.

Results

Inclusion criteria were met by 22 patients (45 levels, mean age 64.3 years). Facet effusions had high sensitivity (90%) but had low specificity (28%) for diagnosis of lumbar instability. Mean T2 relaxation times of right and left facet joints are significantly longer (98.4 ms) in the instability group than they are (87.6 ms) in the stability group (p < 0.001). Anterior translation ratio was positively correlated with mean T2 relaxation times of facet joint (R2 = 0.493, p < 0.05). From a ROC analysis, the cutoff value of T2 relaxation times for lumbar instability was 98.65 ms (sensitivity 60.0%, specificity 95.7%, AUC 0.763).

Conclusions

The T2 relaxation times were positively correlated with lumbar instability. This new quantitative evaluation of lumbar facet joint using MRI T2-mapping might be useful to determine lumbar instability.

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References

  1. Rihn JA, Lee JY, Khan M, Ulibarri JA, Tannoury C, Donaldson WF 3rd, Kang JD (2007) Does lumbar facet fluid detected on magnetic resonance imaging correlate with radiographic instability in patients with degenerative lumbar disease? Spine (Phila PA 1976) 32(14):1555–1560

  2. Fujiwara A, Tamai K, Yamato M, An HS, Yoshida H, Saotome K, Kurihashi A (1999) The relationship between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI Study. Eur Spine J 8(5):396–401

    Article  CAS  Google Scholar 

  3. Chaput C, Padon D, Rush J, Lenehan E, Rahm M (2007) The significance of increased fluid signal on magnetic resonance imaging in lumbar facets in relationship to degenerative spondylolisthesis. Spine (Phila Pa 1976) 32(17):1883–1887

  4. Lattig F, Fekete TF, Grob D, Kleinstück FS, Jeszenszky D, Mannion AF (2012) Lumbar facet joint effusion in MRI: a sign of instability in degenerative spondylolisthesis? Eur Spine J 21(2):276–281

    Article  Google Scholar 

  5. Nieminen MT, Rieppo J, Töyräs J, Hakumäki JM, Silvennoinen J, Hyttinen MM, Helminen HJ, Jurvelin JS (2001) T2 relaxation reveals spatial collagen architecture in articular cartilage: a comparative quantitative MRI and polarized light microscopic study. Magn Reson Med 46(3):487–493

    Article  CAS  Google Scholar 

  6. Watanabe A, Benneker LM, Boesch C, Watanabe T, Obata T, Anderson SE (2007) Classification of intervertebral disk degeneration with axial T2 mapping. AJR Am J Roentgenol 189(4):936–942

    Article  Google Scholar 

  7. Takashima H, Takebayashi T, Yoshimoto M, Terashima Y, Ida K, Shishido H, Imamura R, Akatsuka Y, Shirase R, Fujiwara H, Kubo T, Yamashita T (2014) Investigation of intervertebral disc and facet joint in lumbar spondylolisthesis using T2 mapping. Magn Reson Med Sci 13(4):261–266

    Article  Google Scholar 

  8. Enokida S, Tanishima S, Tanida A, Mihara T, Takeda C, Yamashita E, Nagashima H (2020) Evaluation of age-related changes in lumbar facet joints using T2 mapping. J Orthop Sci 25:46–51

    Article  Google Scholar 

  9. Jeffrey AR, Joon YL, Mustafa K, James AU, Chadi T, William FD, James DK (2007) Does lumbar facet fluid detected on magnetic resonance imaging correlate with radiographic instability in patients with degenerative lumbar disease? Spine (Phila Pa 1976) (32):1555–1560

  10. Schwab F, Patel A, Ungar B, Farcy JP, Lafage V (2010) Adult spinal deformity-postoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery. Spine (Phila Pa 1976) 35(25):2224–2231

  11. Leonid K, Pradeep S, Ali G, Ling L, David JH (2009) Facet orientation and tropism: associations with facet joint osteoarthritis and degenerative spondylolisthesis. Spine (Phila Pa 1976) 34(16):E579–E585

  12. Fujiwara A, Lim TH, An HS, Tanaka N, Jeon CH, Andersson GB, Haughton VM (2000) The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine (Phila Pa 1976) 25(23):3036–3044

  13. Grogan J, Nowicki BH, Schmidt TA, Haughton VM (1997) Lumbar facet joint tropism does not accelerate degeneration of the facet joints. AJNR Am J Neuroradiol 18(7):1325–1329

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Caterini R, Mancini F, Bisicchia S, Maglione P, Farsetti P (2011) The correlation between exaggerated fluid in lumbar facet joints and degenerative spondylolisthesis: prospective study of 52 patients. J Orthop Traumatol 12(2):87–91

    Article  CAS  Google Scholar 

  15. Kirkaldy-Willis (1985) Presidential symposium on instability of the lumbar spine. Spine 10:254

    Article  Google Scholar 

  16. Wang D, Yuan H, Liu A, Li C, Yang K, Zheng S, Wang L, Wang JC, Buser Z (2017) Analysis of the relationship between the facet fluid sign and lumbar spine motion of degenerative spondylolytic segment using Kinematic MRI. Eur J Radiol 94:6–12

    Article  CAS  Google Scholar 

  17. Lattig F, Fekete TF, Kleinstück FS, Porchet F, Jeszenszky D, Mannion AF (2015) Lumbar facet joint effusion on MRI as a sign of unstable degenerative spondylolisthesis: should it influence the treatment decision? J Spinal Disord Tech 28(3):95–100

    Article  Google Scholar 

  18. Tamai K, Kato M, Konishi S, Matsumura A, Hayashi K, Nakamura H (2017) Facet effusion without radiographic instability has no effect on the outcome of minimally invasive decompression surgery. Global Spine J 7(1):21–27

    Article  Google Scholar 

  19. Miyashita T, Ataka H, Kato K, Tanno T (2015) Good clinical outcomes and fusion rate of facet fusion with a percutaneous pedicle screw system for degenerative lumbar spondylolisthesis: minimally invasive evolution of posterolateral fusion. Spine (Phila Pa 1976) 40(9):E552–E557

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Shuhei Iwata, Yawara Eguchi, Hiromitsu Takaoka, Sumihisa Orita, Kazuhide Inage, Yasuhiro Shiga, Takeo Furuya, Satoshi Maki, Junichi Nakamura, Shigeo Hagiwara & Seiji Ohtori

  2. Department of Orthopaedic Surgery, Shimoshizu National Hospital, Shikawatashi, Yotsukaido, Chiba, 934-5284-0003, Japan

    Yawara Eguchi & Junya Koroki

  3. Chiba University Center for Frontier Medical, Engineering 1-33 Yayoi-cho, CFME room#B201, Inage-ku, Chiba, 263-8522, Japan

    Sumihisa Orita

  4. Department of Orthopaedic Surgery, Eastern Chiba Medical Center, 3-6-2, Okayamadai, Togane, Chiba, 283-8686, Japan

    Atsuya Watanabe, Yasuchika Aoki & Masahiro Inoue

  5. Department of Orthopedic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-City, Ibaraki, 305-8575, Japan

    Masao Koda & Hiroshi Takahashi

  6. Department of Orthopaedic Surgery, St. Marianna University School of Medicine, 2-16-1Miyamae-ku, SugaoKawasaki, Kanagawa, 216-8511, Japan

    Tsutomu Akazawa

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  1. Shuhei Iwata
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  2. Yawara Eguchi
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  3. Hiromitsu Takaoka
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  4. Junya Koroki
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  7. Yasuhiro Shiga
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  8. Takeo Furuya
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  9. Satoshi Maki
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  12. Atsuya Watanabe
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  13. Yasuchika Aoki
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  14. Masahiro Inoue
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  15. Masao Koda
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  16. Hiroshi Takahashi
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  17. Tsutomu Akazawa
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  18. Seiji Ohtori
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Correspondence to Shuhei Iwata.

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Iwata, S., Eguchi, Y., Takaoka, H. et al. MRI T2-mapping of lumbar facet joints is effective for quantitative evaluation of lumbar instability in patients with degenerative lumbar disorders. Eur Spine J 31, 1479–1486 (2022). https://doi.org/10.1007/s00586-022-07119-9

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  • DOI: https://doi.org/10.1007/s00586-022-07119-9

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