DOI: http://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20201599

The assessment of pain, flexibility and daily activity level in the patients who had facet tropism

Busra Kizilkan, Cetin Sayaca, Ozlem Turkoglu

Abstract


Background: The aim of this study to investigate the relationship between asymmetric angular value in lumbar facet joints and pain, flexibility and daily activity level.

Methods: The study included 51 patients with complaint of low back pain (LBP) and underwent lumbar magnetic resonance imaging. Facet joint angle measurements of L4-L5 and L5-S1 were measured. Visual analogue scale (VAS) was used for severity of pain. Joint range of motions (ROM) was measured via goniometry. Body extensibility measurements were performed via body hyperextension test. The Nottingham health profile scale was used to assess daily activity level of individuals.  

Results: The VAS values of patients with tropism were significantly higher (p=0.016). There wasn’t significance difference in ROM and flexibility (p=0.784). In patient group with facet tropism, there was limit of lateral flexion towards the side where the facet joint angle was larger than the control group (p=0.002). There was no significant difference between daily activity levels of both groups (p=0.755).

Conclusions: Pain severity of facet tropism patients is higher. Patients with facet tropism had lateral flexion restriction. In the light of these findings, when the lateral flexion limitation is detected in individuals with complaints of pain without discopathy, it’s necessary to make MR measurements in differential diagnosis by considering facet joint tropism, and to plan physiotherapy and rehabilitation programs. As a result, tropism should be questioned in patients suffering from LBP and limited lateral flexion. There is need for studies in which different evaluation and treatment methods are applied for tropism.

 


Keywords


Facet joint, Tropism, Daily activity level, Pain, Flexibility, Low back pain

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References


Yang KH, King AI. Mechanism of facet load transmission as a hypothesis for low-back pain. Spine. 1984;9(6):557-65.

Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N. Clinical features of patients with pain stemming from the lumbar zygapophysial joints. Is the lumbar facet syndrome a clinical entity. Spine. 1994;19(10):1132-7.

Kundakci YE. Faset Eklemlerin Disk Dejenerasyon’lu Ve Spondilolistezis’li Hastalarda Manyetik Rezonans Goruntuler Ile Degerlendirilmesi. Dissertation, Turkey Republic Selcuk University Health Science Instıtute. 2016: 34-36.

Cyron BM, Hutton WC. Articular tropism and stability of the lumbar spine. Spine. 1980;5(2):168-72.

Bogduk N. International Spinal Injection Society Guidelines for the Performance of Spinal Injection Procedures: Part 1: Zygapophysial Joint Blocks. The Clinical J Pain. 1997;13(4):286-92.

Jackson RP. The facet syndrome. Myth or reality. Clin Orthop Related Res. 1992;279:110-21.

Kalichman L, Hunter DJ. Lumbar facet joint osteoarthritis: a review. In Seminars in arthritis and rheumatism. Semin Arthritis Rheum. 2007;37(2):69-80.

Schulz KF, Altman DG, Moher D. Consort 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC Med. 2010;8(1):18.

Fredy M. The Graphic Rating Scale. J Educ Psychol. 1923;14:83-102.

Keele Kd. Lond MD. The Paın Chart. Lancet. 1948;252(6514);6-8.

Otman SA, Demirel H, Sade A. Tedavi hareketlerinde temel degerlendirme prensipleri. Hipokrat. 1998;7(2):55-73.

Kucukdeveci AA, Kenna MSP, Kutlay S, Gursel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehab Res. 2000;23(1):31-38.

Alonso F, Kirkpatrick CM, Jeong W, Fisahn C, Usman S, Rustagi T, et al. Lumbar facet tropism: a comprehensive review. World Neurosurg. 2017;102:91-96.

Liu Z, Duan Y, Rong X, Wang B, Chen H, Liu H. Variation of facet joint orientation and tropism in lumbar degenerative spondylolisthesis and disc herniation at L4-L5: a systematic review and meta-analysis. Clin Neurol Neurosurg. 2017;161:41-47.

Gao T, Lai Q, Zhou S, Liu X, Liu Y, Zhan P, et al. Correlation between facet tropism and lumbar degenerative disease: a retrospective analysis. BMC Musculoskeletal Disorders. 2017;18(1):483.

Murtagh FR, Paulsen RD, Rechtine GR. The role and incidence of facet tropism in lumbar spine degenerative disc disease. J Spinal Disorders. 1991;4(1):86-89.

Rong X, Wang B, Ding C, Deng Y, Chen H, Meng Y, et al. The biomechanical impact of facet tropism on the intervertebral disc and facet joints in the cervical spine. The Spine J. 2017;17(12):1926-31.

Ko H, Park B. Facet Tropism In Lumbar Motion Segments and Its Significance In Disc Herniation. Arch Phys Med Rehabil. 1997;78:1211-4.

Binder DS, Nampiaparampil DE. The provocative lumbar facet joint. Current Rev Musculoskeletal Med. 2009;2(1):15-24.

Schellinger D, Wener L, Ragsdale BD, Patronas NJ. Facet joint disorders and their role in the production of back pain and sciatica. Radiographics. 1987;7(5):923-44.

Do DH, Taghavi CE, Fong W, Kong MH, Morishita Y, Wang JC. The relationship between degree of facet tropism and amount of dynamic disc bulge in lumbar spine of patients symptomatic for low back pain. European Spine J. 2011;20(1):71-8.

Narin S, Bozan O, Cankurtaran F, Bakırhan S. Kronik bel agrili hastalarda fizyoterapi programının fonksiyonel kapasite ve yasam kalitesi uzerine etkisi. Dokuz Eylul Universitesi Tip Fakultesi Dergisi. 2008;22(3):137-43.

Magee DJ. Orthopedic Physical Assessment. Philadelphia: WB Saunders Company; 1997: 362-415.