European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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The role of MRI in assessing facet joint osteoarthritis is unclear. By developing a grading system for severity of facet joint osteoarthritis on MRI, the relationship between disc degeneration and facet joint osteoarthritis was determined. The accuracy of MRI in assessing facet joint osteoarthritis against CT was 94%. ⋯ No facet joint osteoarthritis was found in the absence of disc degeneration and most facet joint osteoarthritis appeared at the intervertebral levels with advanced disc degeneration. Disc degeneration is more closely associated with aging than with facet joint osteoarthritis. The present study supports the hypothesis that "disc degeneration precedes facet joint osteoarthritis", and also supports the concept that it may take 20 or more years to develop facet joint osteoarthritis following the onset of disc degeneration.
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Whiplash motion of the neck is characterized by having an extension-flexion motion of the neck. It has been previously assumed that muscles do not play a role in the injury. Eight healthy males were seated in a car seat mounted on a sled. ⋯ Shorter reaction times were found to be as low as 13.2 ms from head acceleration and 65.6 ms from sled acceleration. Thus the muscles could influence the injury pattern. It is of interest that clinical symptoms are often attributed to muscle tendon injuries.
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Fracture of a spinal segment with minimal or no compression of the vertebral body can be highly unstable. Screening for such an injury in the lumbar spine is often obstructed in a multi-injured patient, because of difficulty in obtaining adequate sagittal radiographs. The position of the spinous processes in relation to each other is the key for proper evaluation of the status of the posterior stabilising structures. ⋯ The mean values and 99% confidence limits for changes in the interspinal process distances between adjacent spinal levels were determined and analysed in relation to age, gender and spinal segment level. An upper limit of a normal difference in distance between the spinous processes at two adjacent levels was determined to be 7-10 mm, depending on age and location in the lumbar spine. A difference in interspinal process distance exceeding 7 mm between two adjacent lumbar levels should alert a surgeon to severe and unstable injury.
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We investigated the prognosis of low-back pain and the association of clinical symptoms and anatomic findings among young athletes. Consecutive patients, aged between 12 and 18 years, who had low-back pain that had interfered with their training for at least 4 weeks were included in the case series. All the patients participated in a standardized interview and clinical examination, and plain radiographs and magnetic resonance images were also obtained. ⋯ In conclusion, the reasons for prolonged back pain among young athletes are usually established by imaging studies. A knowledge of anatomic abnormalities may help in tailoring training programmes and avoiding the progression of changes during growth. Simple restriction of painful activities usually leads to good recovery.