title: A radiographic evaluation of facet sagittal angle in cervical spinal cord injury without major fracture or dislocation.
abstract: METHODS
  A retrospective radiographic study with a minimum 2-year follow-up.
  
  
  OBJECTIVE
  To evaluate the relationships between the cervical articular facets' morphology and the incidence of traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation.
  
  
  METHODS
  Spinal Injuries Center, Japan.
  
  
  METHODS
  This study included 113 patients with traumatic CSCI without major fracture or dislocation. Eighty-four healthy volunteers without neurological deficits or cervical cord pathology on magnetic resonance imaging (MRI) were defined as control subjects. We used a plain sagittal radiograph to measure the facet sagittal angles (FSA) at four cervical segments in all the CSCI patients and controls. We defined the FSA as the angle between the inferior margin of the superior cervical spinal body and the inferior articular process of the superior vertebra.
  
  
  RESULTS
  Most frequent incidence of CSCI was seen at C3-4 segment (54%). With respect to CSCI at C3-4 segment, 55.7% of the subjects showed smallest FSA at C3-4 segment.
  
  
  CONCLUSIONS
  Most of the traumatic CSCI at C3-4 segment showed raised cervical articular facets at C3-4 segment. On the basis of our results, we hypothesized that the raised cervical articular facets might have an important role in the etiology of traumatic CSCI. The cervical spinal cord at the C3-4 segment might receive the highest load during acute hyperextension of the cervical spine because of the C3-4 articular facets' morphology.
authors.affiliation: Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Takao
authors.affiliation: Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kubota
authors.affiliation: Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Maeda
authors.affiliation: Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Okada
authors.affiliation: Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Morishita
authors.affiliation: Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Mori
authors.affiliation: Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Yugue
authors.affiliation: Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: O
authors.initials: O
authors.lastname: Kawano
authors.affiliation: Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sakai
authors.affiliation: Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ueta
authors.affiliation: Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Shiba
mesh_terms: D000328:Adult; D066193:Cervical Cord / Q000293:injuries; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000503:physiopathology*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000453:epidemiology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging / Q000209:etiology*; D055815:Young Adult