Degenerative facet joint-injuring arthritis of the lumbar spine

Brief introduction of lumbar degenerative small joint injury arthritis Because of the degenerative changes affecting one or all of the small joints behind the lumbar spine, it is a symptom of arthritis and a symptom of low back pain. It is called lumbar degenerative joint arthritis. basic knowledge The proportion of illness: 0.02% Susceptible people: no special people Mode of infection: non-infectious Complications: severe wedge deformation of the vertebral body with subluxation of the facet joint

Lumbar degenerative small joint injury arthritis cause

(1) Causes of the disease

It is caused by the degenerative change of the facet joint itself; it can also be secondary to bilateral axon asymmetry, lumbar disc degeneration or lumbar disc herniation.

(two) pathogenesis

When the nucleus pulposus water decreases or the nucleus pulposus protrudes, the intervertebral space narrows, changing the normal structure of the facet joint, causing the adjacent two facet joints to overlap, and the fiber loop becomes slack, and the activity between the vertebral bodies The enlargement affects the stability of the facet joints. Later, the cartilage surface and the subchondral are affected. Due to the tear of the surrounding joint capsule wall, the epiphysis gradually forms the epiphysis, and the joint capsule is loosened and moved due to the degenerative change of the facet joint. The formation of the bite and the callus can cause the spinal nerve root to be jammed or stimulated, resulting in low back pain.

Lumbar degenerative small joint injury arthritis prevention

Avoid overwork, pay attention to work and rest, pay attention to the regularity of life.

Lumbar degenerative small joint injury arthritis complications Complications severe wedge deformation of the vertebral body with subluxation of the facet joint

A small number of patients may have lumbar spondylolisthesis and facet joint subluxation.

Lumbar degenerative small joint injury arthritis symptoms Common symptoms After exercise, low back pain, lower extremity radiation pain

Symptom

(1) Low back pain: It is persistent dull pain or soreness, which is aggravated after the activity. In the acute attack, the waist can be stiff, and there is generally no waist movement disorder.

(2) Root symptoms: When the nerve root is stimulated, radiation pain of the lower extremity may occur, and the range of involvement is relatively limited. The pain does not completely spread according to the distribution area of the nerve root.

2. There are fixed tenderness at the small joints of the signs, the tender points are deep, there are slap pain and conduction pain. In acute attacks, the lumbar spine physiological curvature can disappear, the lumbar spine processes are not aligned, and the distance between the spinous processes of the spine increases. Pressurized here, a depression can occur.

Examination of lumbar degenerative small joint injury arthritis

1. X-ray film needs to take lumbar vertebrae, lateral position and left and right 45° oblique X-ray film. There is no obvious positive finding in the early stage. Sometimes the lumbar facet joints are arranged asymmetrically, the small joint space is narrow and loose, and later, The joints of the affected area proliferated, the facet joints were hardened, the upper articular processes protruded upward and there was osteophyte formation, which showed hypertrophic changes. Due to the formation of osteophytes around the small joints, the intervertebral foramen became smaller, and a few patients had pseudo lumbar spondylolisthesis. In the lumbar extension-flexion dynamic imaging, the degree of lumbar spondylolisthesis caused by unstable joints of the small joints is more obvious.

2. Volume film and CT examination.

(1) Tomography: It is possible to show changes in the stenosis of the facet joint and the formation of the callus.

(2) CT examination: The degree of small joint lesions and its anatomical relationship with the nerve root canal and spinal canal can be clearly displayed.

Diagnosis and diagnosis of lumbar degenerative small joint injury arthritis

1. Clinical manifestations such as the aforementioned clinical symptoms and local signs.

2. Partial closure test with 1% procaine 5 ~ 10ml, with an intracardiac injection needle into the small joint around the lesion, if the symptoms of low back pain after 10min reduced or disappeared, it is positive, which is helpful for the diagnosis of this disease.

3. Imaging findings are based on X-ray film, tomography or CT film to assist in diagnosis.

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