{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T14:24:10Z","timestamp":1793283850590,"version":"4.5.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Controversy exists in the literature about whether facet effusions and other degeneration parameters are associated with instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess the association between facet effusions and other lumbar degeneration parameters and segmental instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>In this study, 207 L4\u2013L5 and L5\u2013S1 levels in 104 patients were assessed. We divided the spinal levels into two groups: the small facet effusions (SFE) group in whom facet effusions were &lt;1.5 mm or non-effusions were found, and the large facet effusions (LFE) group in whom they were \u22651.5 mm. The association between other degeneration parameters and instability was also assessed, such as disc degeneration, Modic changes (MC), spondylolisthesis, facet orientation and tropism, facet subchondral sclerosis, and facet cartilage degeneration. Furthermore, we subdivided the levels into subgroups to evaluate the association of LFE and instability within each one.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The main analysis comparing the presence of instability in SFE and LFE groups showed a non-statistically significant association between LFE and instability. The presence of MC type 1 and the existence of L4\u2013L5 spondylolisthesis had a statistically significant association with instability. In the subset of 43 levels with L4\u2013L5 degenerative spondylolisthesis, the presence of LFE and the existence of MC type 1 reached a significant association with instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The presence of LFE and\/or MC type 1 may act as red flags in patients with L4\u2013L5 degenerative spondylolisthesis to suspect segmental instability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0028-3886.360912","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T03:28:48Z","timestamp":1692847728000},"page":"S224-S229","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Lumbar Facet Effusions and Other Degeneration Parameters and Its Association with Instability"],"prefix":"10.4103","volume":"70","author":[{"given":"Dami\u00e1n","family":"Bendersky","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mart\u00edn","family":"Asem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Navarrete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-21-20240907","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1097\/BRS.0b013e318113271a","article-title":"The significance of increased fluid signal on magnetic resonance imaging in lumbar facets in relationship to degenerative spondylolisthesis","volume":"32","author":"Chaput","year":"2007","journal-title":"Spine (Phila Pa 1976"},{"key":"R2-21-20240907","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1055\/s-0036-1583173","article-title":"Facet effusion without radiographic instability has no effect on the outcome of minimally invasive decompression surgery","volume":"7","author":"Tamai","year":"2017","journal-title":"Global Spine J"},{"key":"R3-21-20240907","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1590\/s1808-185120191803196641","article-title":"Image correlation between facet effusion and lumbar instability","volume":"18","author":"Fernandes Junior","year":"2019","journal-title":"Coluna"},{"key":"R4-21-20240907","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1007\/s00586-011-1993-1","article-title":"Lumbar facet joint effusion in MRI: A sign of instability in degenerative spondylolisthesis?","volume":"21","author":"Lattig","year":"2012","journal-title":"Eur Spine J"},{"key":"R5-21-20240907","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/BSD.0b013e318269c261","article-title":"Lumbar facet joint effusion on MRI as a sign of unstable degenerative spondylolisthesis: Should it influence the treatment decision?","volume":"28","author":"Lattig","year":"2015","journal-title":"J Spinal Disord Tech"},{"key":"R6-21-20240907","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1097\/BRS.0b013e318067dc55","article-title":"Does lumbar facet fluid detected on magnetic resonance imaging correlate with radiographic instability in patients with degenerative lumbar disease?","volume":"32","author":"Rihn","year":"2007","journal-title":"Spine (Phila Pa 1976"},{"key":"R9-21-20240907","doi-asserted-by":"crossref","first-page":"37","DOI":"10.14444\/2037","article-title":"Development of a novel radiographic measure of lumbar instability and validation using the facet fluid sign","volume":"9","author":"Hipp","year":"2015","journal-title":"Int J Spine Surg"},{"key":"R10-21-20240907","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1007\/s13244-018-0638-x","article-title":"Facet joint syndrome: From diagnosis to interventional management","volume":"9","author":"Perolat","year":"2018","journal-title":"Insights Imaging"},{"key":"R11-21-20240907","doi-asserted-by":"crossref","first-page":"3521","DOI":"10.2147\/JPR.S227153","article-title":"Prevalence of facet effusion and its relationship with lumbar spondylolisthesis and low back pain: The Wakayama spine study","volume":"12","author":"Shinto","year":"2019","journal-title":"J Pain Res"},{"key":"R12-21-20240907","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1097\/00003086-198205000-00015","article-title":"Instability of the lumbar spine","volume":"165","author":"Kirkaldy-Willis","year":"1982","journal-title":"Clin Orthop Relat Res"},{"key":"R13-21-20240907","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1007\/s00586-008-0758-y","article-title":"Modic changes: A systematic review of the literature","volume":"17","author":"Zhang","year":"2008","journal-title":"Eur Spine J"},{"key":"R14-21-20240907","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1097\/00007632-199006000-00028","article-title":"Lumbar spinal fusion. 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