COMPARATIVE ANALYSIS OF RADIOLOGIC ASPECTS OF FACET JOINTS IN SURGICAL TREATMENT OF PATIENTS WITH DEGENERATIVE DISEASES OF THE LUMBAR SPINE

• Main Authors: A. Ye. Krivoshein, V. P. Konev, S. V. Kolesov, S. N. Moskovsky
• Format: Article
• Language: Russian
• Published: Kubankurortresurs, OOO 2021-03-01
• Series: Инновационная медицина Кубани
• Subjects: disc degeneration; facet joint; adjacent disc; multispiral computed tomography
• Online Access: https://inovmed.elpub.ru/jour/article/view/369

Objective To study the radiologic characteristics of facet joints at different stages of the degenerative process in the lumbar spine to determine the indications for various methods of fixing the affected segment and to evaluate the results of treatment.Material and Methods To determine the radiologic aspects of facet joints in the affected area and in  adjacent segments of the lumbar spine, two groups were formed, including 136 patients who underwent multispiral computed tomography in two-energy mode before surgery and 12 months after surgery. Group I included patients who underwent rigid fixation of the spine (360°), and group II included patients who underwent dynamic fixation using nitinol rods (180°).Results Based on a comprehensive instrumental study, it was found that the degeneration of the intervertebral disc according to Pfirrmann II and III revealed an increase in the density of the cartilaginous plate in facet joints (HU). These digital indicators confirm the preservation of joint functionality, both in the affected area and in adjacent segments. With severe degrees of disk degeneration in Pfirrmann IV and V and facet joints, deep pathological changes occurred, directed towards the loss of facet joints functionality.Conclusion The obtained digital indicators of dual-energy computed tomography for the state of facet joints  in combination with the results of magnetic resonance imaging can be used as criteria in a complex of patient studies to assess the degree of degeneration of the vertebral motion segment in the affected area and adjacent segments. We recommend using these criteria as a diagnostic component for finding optimal methods of surgical treatment.