METHODS: Overall, we retrospectively recruited 390 consecutive patients with CDH who underwent surgical treatment at our institution and 50 normal participants. Clinical variables and radiological findings related to CDH were collected.
RESULTS: Patients with CDH were more likely to have a higher absolute value of the facet asymmetry factor (FAF) (p < .001), in which the FAF value of the left group was significantly higher than the other groups (p < .001) and the right group was lower than the central group (p < .001). 9.62% (C3/4), 12.19% (C4/5), 8.70% (C5/6), and 8.14% (C6/7) were determined as cutoff values for each variable that maximized sensitivity and specificity. Furthermore, multivariate analysis showed that cross-sectional area asymmetry of the facet joint (FCAA) was an independent risk factor for the occurrence of CDH. Also, the Chi-square test showed a significant difference in the distribution of the degeneration classification of the disc between the facet-degenerated group and the nondegenerated group at C5/6 (p = 0.026) and C6/7 (p = 0.005) in the facet asymmetry (FA) group.
CONCLUSIONS: FCAA is evaluated as an independent risk factor for CDH and associated with the orientation of disc herniation. And facet joint orientation may also play a role in cervical spine degeneration rather than facet joint tropism.
方法:总的来说,我们回顾性招募了在我们机构接受手术治疗的390例CDH患者和50例正常参与者.收集与CDH相关的临床变量和放射学发现。
结果:患有CDH的患者更可能具有较高的小平面不对称因子(FAF)绝对值(p<.001),其中左组FAF值显著高于其他组(p<.001),右组低于中心组(p<.001)。9.62%(C3/4),12.19%(C4/5),8.70%(C5/6),和8.14%(C6/7)被确定为每个变量的截断值,这些变量最大化了灵敏度和特异性。此外,多因素分析显示,小关节横截面面积不对称(FCAA)是CDH发生的独立危险因素。此外,卡方检验显示,在小平面不对称(FA)组中,小平面退变组和非退变组的椎间盘退变分类分布在C5/6(p=0.026)和C6/7(p=0.005)有显著差异.
结论:FCAA被评估为CDH的独立危险因素,并与椎间盘突出的方向相关。小关节定向也可能在颈椎退变中发挥作用,而不是小关节定向。