The correlation of axiaThe correlation of axial rotation of the lumbar spine with degenerative disease of disk and lumbar end plates and apophyseal joint orientationl rotation of the lumbar spine with degenerative disease of disk and lumbar end plates and apophyseal joint orientation

Abstract

Back pain is considered as the second common patient`s symptom (after headache) in the United States. Decreased stability of spinal motion segments is the one of probable mechanisms of low back pain. As yet, a few studies deliberated imaging characteristics of degenerative changes associated with spinal instability such as axial rotation and documented criterias has not been suggested in the refrence books. Missed axial instability is the one probable cause of inappeasement patient`s symptom after disk surgery. In this study we determine relationship between axial rotation of lumbar vertebrae and degenerative changes of disk and end plates and apophyseal joint plane.Materials and methods: We evaluated MR study of lumbosacral vertebrae of 709 patients, finally we found 50 patients with axial rotation of lumbar vertebrae. Also, 50 patients without axial rotation random selected as control group. Results: The patients with axial rotation (case group) include 29 females and 21males with 39-61 years old age. In 50 patients with axial rotation, 36 patients (72% of patients) had clockwise axial rotation and 14 patients (28% of patients) had counterclockwise axial rotation.In case group 0% of patients had complete hydration, 38% of patients had relative dehydration and 62% of patients had complete dehydration, 100% of patients had decreased height of disk, 12% of patients didn`t have disk bulging and herniation, 22% of patients had disk bulging, 56% of patients had protrusion, 8% of patients had extrusion, 2% of patients had sequestration, 18% of patients had osteophyte formation, 34% of patients had normal signal of end plates, 30% of patients had type 1 signal changes, 26% of patients had type 2 signal changes, 10% of patients had type 3 signal changes. Also, in 36 patients with clockwise axial rotation 100% of patients had decreased angle of left apophyseal joint plane and increased angle of right apophyseal joint plane. Also, in 14 patients with counterclockwise axial rotation 100% of patients had increased angle of left apophyseal joint plane and decreased angle of right apophyseal joint plane.In case group, in 36 patients with clockwise axial rotation 100% of patients had decreased left neuroforaminal AP diameter. Also, in 14 patients with counterclockwise axial rotation 100% of patients had decreased right neuroforaminal AP diameter.