Prevalence and Clinical Impact of Cervical Facet Joint Degeneration on Degenerative Cervical Myelopathy: A Novel Computed Tomography Classification Study

• Material Type: 博士論文
• Title: Prevalence and Clinical Impact of Cervical Facet Joint Degeneration on Degenerative Cervical Myelopathy: A Novel Computed Tomography Classification Study
• Author/Editor: Okamoto, Ai; Takeshima, Yasuhiro; Yokoyama, Shohei; Nishimura, Fumihiko; Nakagawa, Ichiro; Young-Soo, Park; Nakase, Hiroyuki
• Author Heading: Okamoto, Ai; Takeshima, Yasuhiro; Yokoyama, Shohei; Nishimura, Fumihiko; Nakagawa, Ichiro; Young-Soo, Park; Nakase, Hiroyuki
• Publication, Distribution, etc.: Korean Spinal Neurosurgery Society
• Publication Date: 2022-06
• Publication Date (W3CDTF): 2022-06
• Alternative Title: 頸椎症性脊髄症における椎間関節変性の有病率と臨床的影響：CT新分類での検討
• Periodical title: Neurospine
• No. or year of volume/issue: 19 2
• Volume: 19
• Issue: 2
• Pages: 393-401
• ISSN (Periodical Title): ISSN : 2586-6583
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2023-03-15
• Dissertation Number: 甲第870号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Articular; Cervical myelopathy; Degenerative; Computed tomography; Facet joint; Spondylolisthesis
• Target Audience: 一般
• Note (General): type:Thesis; Objective: To evaluate cervical facet joint degeneration using a newly developed classification, investigate its prevalence and relationship with cervical degenerative spondylolisthesis, and clarify its clinical significance in patients with degenerative cervical myelopathy (DCM). Methods: This study included 145 consecutive patients with DCM who underwent surgical treatment. Clinical variables and radiological findings were analyzed. A new 6-grade computed tomography (CT) classification for cervical facet joint degeneration was adapted, and its prevalence was evaluated by categorizing the joints into those at responsible and those at nonresponsible spinal segmental levels. We evaluated the association between rapidly progressive myelopathy and the presence of significant facet joint degeneration or spondylolisthesis at the responsible segmental level. Results: Finally, 140 patients with a mean age of 64.1±12.8 years were analyzed. The prevalence of grade 1, 2, 3, 4, 5A, and 5B classification in all facet joints was 72.0%, 9.5%, 10.9%, 4.3%, 2.9%, and 0.4%, respectively. There was a statistically significant difference in the distribution of CT grades between the joints at the responsible and nonresponsible segmental levels (p<0.001), with a high prevalence of grade 4 or 5B degeneration at the responsible segmental level, reflecting articular irregularity. There was also a statistically significant relationship between rapidly progressive myelopathy and grade 4 or 5B degeneration at the responsible segmental level (p<0.001), but not between rapidly progressive myelopathy and spondylolisthesis (p=0.255). Conclusion: This novel CT classification for facet joints deserves additional evaluation in patients with DCM. Abnormal findings on the articular surfaces might be related to the progression of myelopathy.; 博士（医学）・甲第870号・令和5年3月15日; © 2022 by the Korean Spinal Neurosurgery Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.; identifier:Neurospine Vol.19 No.2 p.393-401 (2022 Jun); identifier:25866583; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4102; identifier:Neurospine, 19(2): 393-401
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.14245/ns.2143258.629
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4102/1/01%e7%94%b2870%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

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