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Reliability of Human Lumbar Facet Joint Degeneration Severity Assessed by Magnetic Resonance Imaging. Little Joshua W,Grieve Thomas,Cantu Joseph,Bogar William C,Heiser Rudy,Miley Heather,Cramer Gregory D Journal of manipulative and physiological therapeutics OBJECTIVE:The purpose of this study was to determine the reliability of the assessment of lumbar facet joint degeneration severity by analyzing degeneration subscales using magnetic resonance imaging (MRI) in human participants. METHODS:The reliability of articular cartilage degeneration, subchondral bone sclerosis, and osteophyte formation subscales of lumbar facet joint degeneration severity was assessed in MRI images from n = 10 human participants. Each scale was applied to n = 20 lumbar facet joints (L4/5 level). Three examiners were trained. A first assessment of MRI images was provided by the examiners followed by a second assessment 30 days later. Intraobserver and interobserver reliability were determined using percent agreement, the weighted kappa coefficient κ for paired comparisons, and the overall weighted kappa κ. The minimum threshold for reliability was set at moderate levels of agreement, κ > 0.40, based upon previous recommendations. RESULTS:The articular cartilage subscale had acceptable intraobserver (κ = 0.51) and interobserver (κ = 0.41) reliability. Scales for subchondral bone sclerosis (intraobserver κ = 0.28; interobserver κ = 0.10) and osteophyte formation (intraobserver κ = 0.26; interobserver κ = 0.20) did not achieve acceptable reliability. CONCLUSION:Of the 3 subcategories of lumbar facet joint degeneration, only articular cartilage degeneration demonstrated acceptable reliability. Subscales of lumbar facet joint degeneration should be considered independently for reliability before combining subscales for a global degeneration score. Owing to the inherent difficulty of assessing lumbar facet joint degeneration, the use of multiple examiners independently assessing degeneration with reliable scales and then coming to a consensus score upon any disagreements is recommended for future clinical studies. 10.1016/j.jmpt.2018.11.027
Evaluation of MRI and CT parameters to analyze the correlation between disc and facet joint degeneration in the lumbar three-joint complex. Song Quanwei,Liu Xuqiang,Chen De-Jian,Lai Qi,Tang Benyu,Zhang Bin,Dai Min,Wan Zongmiao Medicine Lumbar 3-joint complex degeneration is a multifactorial, pathological process. Previous studies included insufficient quantitative analyses to prove the relationship between disc degeneration and facet joint osteoarthritis (OA). We assessed the correlation between intervertebral disc and lumbar facet joint degeneration using computed tomography (CT) and magnetic resonance imaging (MRI) parameters.A total of 152 participants who underwent conventional MRI and CT in the clinostat position were included in this study. The presence of lumbar disc degeneration was identified using the Pfirrmann grading system, and the presence of lumbar facet joint degeneration was identified using the Weishaupt grading system. Facet tropism was defined as a divergence more than 7° between the facet joint angles of both sides at the same segment. The intervertebral disc heights were also measured.Most facet joint OA probably appeared at the segment with intervertebral disc degeneration of more than grade III. Facet joint OA was significantly exacerbated with the progression of disc degeneration grade. The intervertebral height significantly decreased with the progression of facet joint degeneration grades, except for grades 0 and 1.Our current study found that each individual joint degeneration influences the other 2 in the lumbar 3-joint complex. Facet tropism was significantly associated with lumbar disc degeneration. Narrowing of the intervertebral disc height probably aggravates the facet joint degeneration further at the same level. 10.1097/MD.0000000000017336