title: The correlation between radiographic and pathologic grading of lumbar facet joint degeneration.
abstract: BACKGROUND
  Before performing spine non-fusion surgery that retains the facet joints, choosing an accurate radiographic method to evaluate the degree of facet joint degeneration is extremely important. Therefore, the objective of this study was to determine the accuracy and reliability of different radiographic classifications by analyzing the correlation between radiographic and pathologic grading of lumbar facet joint degeneration. Taking the pathologic examination as standard, the consistency of computed tomography (CT) and magnetic resonance imaging (MRI) assessment of lumbar facet joint degeneration was compared.
  
  
  METHODS
  A total of 74 facet joints obtained from 42 patients who underwent posterior lumbar surgery were evaluated. All patients underwent CT and MRI before surgery. The pathologic grade was evaluated with a method based on hematoxylin-eosin and toluidine blue staining. The radiographic grade was evaluated using the methods proposed by different authors.
  
  
  RESULTS
  There was a moderate consistency between pathologic and radiographic grading for facet joint degeneration. The weighted kappa coefficients comparing pathologic with radiographic grading were 0.506 for CT, 0.561 for MRI, and 0.592 for CT combined with MRI, respectively. Taking the pathologic examination as standard, the consistency of CT and MRI examination was also moderate, and the weighted kappa coefficient was 0.459.
  
  
  CONCLUSIONS
  The radiographic examination has moderate accuracy and reliability for evaluating degeneration of facet joints. Therefore, a more accurate method for evaluating the degeneration of facet joints is necessary before performing spine non-fusion surgery that retains the facet joints.
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.|Artificial Joint Engineering and Technology Research Center of Jiangxi Province, Nanchang, 330006, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.|Artificial Joint Engineering and Technology Research Center of Jiangxi Province, Nanchang, 330006, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.|Artificial Joint Engineering and Technology Research Center of Jiangxi Province, Nanchang, 330006, China.
authors.forename: Song
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.|Artificial Joint Engineering and Technology Research Center of Jiangxi Province, Nanchang, 330006, China.
authors.forename: Xiao-Xing
authors.initials: XX
authors.lastname: Fu
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.|Artificial Joint Engineering and Technology Research Center of Jiangxi Province, Nanchang, 330006, China.
authors.forename: Xiao-Long
authors.initials: XL
authors.lastname: Yu
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.|Artificial Joint Engineering and Technology Research Center of Jiangxi Province, Nanchang, 330006, China.
authors.forename: Chang-Lin
authors.initials: CL
authors.lastname: Fu
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China. 609901889@qq.com.|Artificial Joint Engineering and Technology Research Center of Jiangxi Province, Nanchang, 330006, China. 609901889@qq.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China. 764932881@qq.com.|Artificial Joint Engineering and Technology Research Center of Jiangxi Province, Nanchang, 330006, China. 764932881@qq.com.
authors.forename: Min
authors.initials: M
authors.lastname: Dai
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult; D021801:Zygapophyseal Joint / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery
keywords: Degeneration; Lumbar facet joint; Pathology; Radiography; Spine non-fusion technique