关节突关节的方向性与腰椎退变性滑脱

目的：探讨腰椎关节突关节的方向性在腰椎退变性滑脱的病因学意义。方法：对５３名Ｌ４～５退变性滑脱患者及５３名正常对照者的ＭＲＩ资料进行分析。分别测量Ｌ４～５关节突关节的方向性及对称性。并根据Ｔ２加权像椎间盘信号强度判定椎间盘退变程度,根据腰椎Ｘ线片记录腰椎滑脱程度。结果：腰椎退变性滑脱患者的关节突关节方向与正常者相比更偏向矢状位（Ｐ〈０．０５）。不对称程度也更为明显（Ｐ〈０．０５）。在退变性滑脱患者     

退变性腰椎滑脱的关节突关节形态学分析

目的：探讨腰椎关节突关节形态学变化在退变性腰椎滑脱（degenerative lumbar spondylolisthesis,DLS）发生中的病因学意义。方法自2007年1月至2013年7月收治的L4,5 DLS患者中随机选取115例作为观察组,男28例,女87例;年龄41~76岁,平均57.3岁。自体检人群（无脊柱滑脱及腰腿痛表现）中随机选取与DLS组年龄、性别相匹配的115例作为对照组,男31例,女84例;年龄45~77岁,平均56.4岁。两组均行腰椎正、侧位X线片,CT平扫及多层面重建检查。于侧位X线片测量DLS组患者腰椎滑脱程度（Taillard指数）,CT图像分别测量滑脱组及对照组L3,4、L4,5节段两侧关节突关节角并评估两组小关节不对称程度,矢状面CT重建图像测量两组L3,4、L4,5关节突关节椎弓根角（pedicle facet angle,P?F角）,对两组相应节段所测角度进行比较分析;CT横断面骨窗下对两组L4,5关节突关节进行退变程度分级并比较,且对DLS组不同退变等级之间的滑脱程度进行分析。对DLS组L4,5的关节突关节角、P?F角与滑脱程度进行相关性分析。结果 DLS组L4,5均为Ⅰ度滑脱。DLS组L3,4、L4,5节段关节突关节角与对照组相应节段相比明显偏向矢状位;P?F角均较对照组大,更倾向于水平位。小关节不对称程度,L4,5节段DLS组与对照组比较差异有统计学意义,而L3,4节段的差异无统计学意义。两组L4,5关节突关节退变程度比较差异有统计学意义,DLS组患者L4,5关节突关节不同退变等级之间,滑脱程度的差异无统计学意义。DLS组L4,5滑脱程度与其关节突关节角、P?F角无相关性。结论关节突关节形态学变化（更小的关节突关节角、水平化的P?F角、小关节不对称）对退变性腰椎滑脱的发生具有一定的病因学意义,但其作用不应被夸大;关节突关节退变是随着年龄增长出现的继发性改变,而腰椎滑脱加剧了小关节的退变。     

体重指数、关节突关节角度与退变性腰椎滑脱的相关性分析

目的探讨体重指数、关节突关节角度变化与退变性腰椎滑脱的相关性。方法选取2016年1月至2017年11月在我院诊断为退变性腰椎滑脱的患者共45例,通过收集同期在我院体检患者90例作为正常组,记录患者体重指数,测量L4～5头侧关节突关节角、尾侧关节突关节角、关节突-椎弓根角、左右关节突关节角是否对称,并对这些参数与退变性腰椎滑脱进行相关性分析。结果退变性腰椎滑脱组与正常组相比较,在体重指数、头侧关节突关节角、尾侧关节突关节角、关节突-椎弓根角之间差异有统计学意义(P0.05);退变性腰椎滑脱组与体重指数、头侧关节突关节角、关节突-椎弓根角可能存在相关性(P0.05);退变性腰椎滑脱组中左右关节突关节角是否对称与滑脱程度间差异具有统计学意义(P=0.04)。结论退变性腰椎滑脱患者与正常人相比较关节突关节角更加趋于矢状化、关节突-椎弓根角趋于水平化。     

腰椎关节突关节的方向和退变程度对退行性腰椎滑脱的影响

目的:探讨退行性腰椎滑脱(degenerative lumbar spondylolisthesis,DLS)患者腰椎关节突关节的方向与退变程度的变化规律及其临床意义.方法:随机选取2002年7月～2007年7月我科收治的DLS患者52例作为观察组,同期年龄、性别相匹配的非DLS志愿肯50例作为对照组.将所有研究对象的CT片、侧位X线片图像输入计算机,测量L4/5关节突关节的关节面与椎体矢状面的夹角、L4椎体前后缘中点连线与椎间关节突关节间隙的央角(关节突关节-椎弓根角),在CT片上观察关节突关节退变的程度,并对所测参数进行相关性分析.结果:DLS患者的关节突关节与椎体欠状面的夹角与对照组比较更偏向呈矢状位(34.93°±9.14°vs 47.22°±5.37°,P＜0.001),关节突关节-椎弓根角更倾向于水平位(113.57°±5.96°vs 102.50°±4.96°,P＜0.001),关节突关节的退变程度与其方向的改变高度相关.结论:DLS与关节突关节方向欠状化及水平化相关,腰椎关节突关节的关节面方向矢状化与关节突关节退变程度高度相关,腰椎关节突关节退变程度及其方向的变化对DLS具有病因学意义.     

退行性腰椎滑脱的小关节影像学结构特点

目的：观测退行性腰椎滑脱（ＤＳ）患者的小关节形态结构,探讨引起退变滑脱可能的局部因素。方法：观察并测量４４例Ｌ４退行性滑脱患者及５０晨滑脱患者的正侧位Ｘ线片上的小关节,包括：Ｌ１下关节空间距（Ｄ）与椎板腰部宽（Ｗ）之比、Ｌ４下关节突长度、小椎 角和小面的改变,对比分析其结构特点。结果．滑脱组Ｌ４／Ｗ／１,小 关节间隙接近矢状位,两组Ｌ４下关节突长度、小椎弓根角在统计学上有显著性差异。结论：下关节突     

退变性腰椎滑脱与峡部裂性腰椎滑脱手术治疗中椎弓根置钉对近端关节突侵扰的对比研究

目的 比较退变性腰椎滑脱与峡部裂性腰椎滑脱手术治疗中椎弓根置钉对近端关节突的侵扰。方法 回顾性分析2017年1月至2020年1月在西安交通大学附属红会医院因腰椎滑脱症行减压融合手术治疗并获得随访的462例,其中退变性腰椎滑脱的235例纳入退变组,峡部裂性腰椎滑脱的227例纳入峡部裂组。比较两组术前及术后1、3、14个月的疼痛视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI）以及术后椎弓根螺钉对近端关节突的侵扰程度。结果 两组病人术后14个月的VAS评分及ODI比较,差异具有统计学意义（P＜0.05）;但其术前及术后1、3个月的指标比较,差异无统计学意义（P＞0.05）。退变组椎弓根置钉对近端关节突的侵扰：0级318钉,Ⅰ级124钉,Ⅱ级28钉,峡部裂组椎弓根置钉对近端关节突的侵扰：0级116钉,Ⅰ级244钉,Ⅱ级94钉,组间比较,差异有统计学意义（Z=-9.050,P＜0.001）。结论 两种不同类型的腰椎滑脱均发生了一定数量螺钉侵袭近端关节突关节的病例,但是峡部裂性腰椎滑脱术后螺钉侵扰关节突的概率和程度均明显高于退变性滑脱组病人,明显影响病人预后。     

微创经椎间孔腰椎椎体间融合术中上位关节突关节侵扰的危险因素分析

【摘要】 目的：研究微创经椎间孔腰椎椎体间融合术（minimally invasive transforaminal lumbar interbody fusion,MIS-TLIF）中经皮椎弓根螺钉对上位关节突关节侵扰的发生情况，分析其相关危险因素。方法：回顾性分析我院2012~2018年行MIS-TLIF治疗的腰椎退行性疾病患者91例，其中男性34例，女性57例，年龄51.1±11.8岁（23~73岁），所有均采用经皮置钉的方式置入椎弓根螺钉，术后3个月均行腰椎CT三维重建，并在轴位、矢状位、冠状位上评价关节突关节侵扰程度并分级： 0级，无侵扰，螺钉不在关节突关节上，且未进入关节突关节面；1级，轻度侵扰，螺钉位于上关节突关节上，但未进入关节突关节；2级，中度侵扰，螺钉经过关节突关节面≤1mm；3级，重度侵扰，螺钉经过关节突关节面。收集患者一般情况[年龄、性别、体质指数（body mass index，BMI）、术前诊断、手术节段、关节突关节退变程度]，在术前、术后腰椎CT及正侧位X线片上测量：解剖相关因素（关节突关节轴径、矢状径、冠状径、关节突关节角、腰椎前凸角、腰椎前凸指数、椎板深度）、置钉相关因素（螺钉内倾角、螺钉尾倾角、螺帽-上关节突间距、近端连接棒露出距离、连接棒预弯），并分析潜在侵扰危险因素。结果：MIS-TLIF经皮置钉造成关节突关节侵扰的椎弓根螺钉总计62枚，轻度侵扰螺钉35枚，中、重度程度侵扰螺钉27枚。患者一般情况分析显示，BMI≥30kg/m2、L5为上位置钉节段作为关节突关节侵扰的独立危险因素（P＞0.05）；年龄、性别、术前诊断、关节突关节退变程度与侵扰无关（P＞0.05）。解剖因素分析显示，关节突关节轴径、矢状径、冠状径均≥12mm或关节突关节角≥40°时，侵扰率显著升高（P＜0.05）；关节突关节侵扰组与非侵扰组在腰椎前凸角、腰椎前凸指数及椎板深度上差异无统计学意义（P＞0.05）。置钉相关因素分析显示，侵扰组较非侵扰组存在较小的螺钉内倾角、螺帽-上关节突间距（P＜0.05），而在螺钉尾倾角、近端连接棒露出距离、连接棒预弯上组间差异无统计学意义（P＞0.05）。结论：对于BMI≥30kg/m2和L5为上位置钉节段的患者，应充分考虑经皮置钉造成关节突关节侵扰的高风险性，且关节突关节肥大（轴径、矢状径、冠状径均≥12mm时）、冠状走行（关节突关节角≥40°）时更易出现上位节段侵扰。     

关节突关节角变化与退变性腰椎滑脱间关系的研究

目的探讨关节突关节角的改变与退变性腰椎滑脱(degenerative lumbar spondylolisthesis,DLS)发生之间的因果关系。方法回顾性选取2011-07-2014-07我科收治的50例L4-5单节段退变性前滑脱患者作为DLS组,另选同期50例无腰腿痛和脊椎滑脱的正常患者作为对照组,且使性别、年龄与DLS组相匹配。两组均行站立位腰椎正侧位X线片及腰椎三维CT检查,在腰椎侧位X线上测量腰椎滑脱指数;在CT矢状位图像上选取平行于L3-4、L4-5、L5-S1椎间隙上缘终板的CT横断位图像作为关节突的头侧部分;过椎弓根下缘且平行于L3-4、L4-5、L5-S1椎间隙下缘终板的CT横断图像作为关节突的尾侧部分,在横断位上进行关节突角度测量,同时在骨窗下对关节突的退变进行评估。结果 DLS组L3-4头侧关节突关节角(61.9±6.3)°大于对照组的(56.3±7.5)°,尾侧关节突关节角(57.1±6.9)°大于对照组的(51.9±6.8)°;DLS组L4-5头侧关节突关节角(55.8±5.6)°大于对照组的(50.2±6.7)°,尾侧关节突关节角(53.2±6.8)°大于对照组的(47.0±5.9)°;DLS组L5-S1头侧关节突关节角(49.1±7.8)°大于对照组的(43.9±6.9)°,尾侧关节突关节角(45.1±6.9)°大于对照组的(41.7±5.1)°,差异均具有显著性(P0.05)。DLS组患者L4-5头尾侧角度差值(2.1±0.8)°小于对照组的(5.0±1.3)°,差异具有显著性(P0.05)。DLS组L4-5左右两侧关节突关节角不对称度(8.0±2.0)°大于对照组的(4.2±1.3)°,差异有显著性(P0.05)。按关节突关节退变等级将DLS患者分成3组,各组间滑脱指数差异具有显著性(P0.05),不同退变等级中头、尾侧关节突关节角度差异具有显著性(r=0.457,P0.05)。结论关节突关节矢状化改变更可能是腰椎退变性滑脱发生预先存在的解剖学因素。     

脊柱－骨盆矢状位参数及关节突关节角度对退变性腰椎滑脱的影响

目的：探讨脊柱-骨盆矢状位参数及关节突关节角度对退变性腰椎滑脱的影响及相关性研究。方法：以2016年7月至2019年9月确诊的120例L₄-L₅单节段退变性滑脱患者为观察对象（滑脱组）,以性别和年龄相匹配的120例L₄-L₅节段退变性椎管狭窄患者为对照（对照组）。通过影像学资料测量如下参数：骨盆入射角（pelvic incidence,PI）,骨盆倾斜角（pelvic tilt,PT）,骶骨倾斜角（sacral slope,SS）,腰椎前凸（lumbar lordosis,LL）,胸椎后凸（thoracic kyphosis,TK）,矢状面平衡（sagittal vertical axis,SVA）,L₄-L₅头侧关节突关节角,尾侧关节突关节角及小关节不对称性。比较两组患者参数的差异并对有意义参数行Logistic回归分析。对退变性腰椎滑脱患者关节突关节方向与脊柱-骨盆参数进行相关性分析。结果：两组患者在PI、PT、LL、SVA、头侧关节突关节角、尾侧关节突关节角差异有统计学意义（P<0.05）;Logistic回归分析发现PI、PT及头侧关节突关节角是腰椎滑脱程度的危险因素（P<0.05）。滑脱组头侧关节突关节矢状化与PI、PT呈现显著相关（P<0.05）。结论：高PI、PT及头侧关节突关节矢状化是腰椎滑脱的危险因素,并且关节突关节矢状化程度和大PI、PT密切相关。     

腰椎关节突关节不对称

对７６名正常人及１７３名因下腰痛而手术患者的Ｘ线平片、ＣＴ扫描及ＭＲＩ资料进行分析以调查腰椎关节突关节的对称性与某些腰椎疾患的联系。在７６名正常对照者中有２１人存在Ｌ４～５或Ｌ５～Ｓ１关节突关节不对称，占２７．６％，而在腰椎手术病人中则有８４例，占４８．６％，差异具有显著性意义（Ｐ＜０．０１），提示腰椎关节突关节的不对称具有病因学意义。     

Orientation and tropism of lumbar facet joints in degenerative spondylolisthesis

The orientation and tropism of the lumbar facet joints at L4-5 level was assessed by magnetic resonance imaging (MRI) in 53 patients with degenerative L4-5 spondylolisthesis and 53 age- and sex-matched normal control subjects. The degree of disc degeneration at the L4-5 level and of vertebral slip on lateral radiographs was also evaluated. Patients with degenerative spondylolisthesis had more sagittally orientated facet joints (P < 0.01) and more significant facet joint tropism (P < 0.05) than normal control subjects. For patients with degenerative spondylolisthesis, the facet joint tropism was significantly correlated with the degree of disc degeneration (P < 0.05). The results suggest that morphological abnormalities of the lumbar facet joints are a predisposing factor in the development of degenerative spondylolisthesis.     

下腰椎小关节的方向性与椎间盘突出和侧隐窝狭窄的关系

目的探讨下腰椎小关节的方向性在椎间盘突出的发生和侧隐窝狭窄的形成中的作用和影响。方法通过腰椎ＣＴ片对下腰椎小关节角度进行测量,并分析、研究小关节的对称性、方向性与椎间盘突出和侧隐窝狭窄的关系。共观察１３６例患者３８６个下腰椎间隙的ＣＴ影像,采用横切关节面角度（ＴＩＦＡ）测量法,测量了７７２个下腰椎小关节角度。结果（１）下腰椎椎间盘突出与小关节对称性无关;（２）在Ｌ４～Ｓ１小关节不对称的间隙中,椎间盘易突向矢状小关节侧;（３）小关节角度小于２０度易发生退行性侧隐窝狭窄症;（４）该组测量的国人下腰椎小关节角度明显小于西方学者测量的欧洲人的角度。结论（１）下腰椎高发椎间盘突出症为特殊体位导致的应力集中所致,与椎间小关节方向性无关;（２）在Ｌ４～Ｓ１椎间隙中,如果椎小关节角度不对称将影响椎间盘突出的方向;（３）下腰椎小关节角度太小易导致退行性侧隐窝狭窄的发生。     

退变性腰椎滑脱中腰椎-骨盆结构参数的特点分析

目的:分析退变性腰椎滑脱(degenerative lumbar spondylolisthesis,DLS)中腰椎-骨盆结构特点及其在退变性腰椎滑脱症中的意义。方法:对2015年4月至2017年1月收治的45例单纯退行性L_(4,5)节段腰椎滑脱患者(滑脱组)的临床资料进行回顾性分析,并与同期50例(对照组)体检资料齐全的健康者进行比较。通过影像学资料对受试者的腰椎-骨盆结构参数进行统计分析,分析DLS患者的脊柱-骨盆特点。观察退变性腰椎滑脱患者椎间盘及关节突关节退变特点。利用Spearson分析各观察项目之间的相关性。结果:滑脱组L_(4,5)关节突关节角、腰椎前凸角、骨盆入射角、骨盆倾斜角、骶骨倾斜角为(36.5±11.2)°、(44.2±7.3)°、(66.5±11.6)°、(22.2±10.0)°、(33.4±11.3)°。对照组L_(4,5)关节突关节角、腰椎前凸角、骨盆入射角、骨盆倾斜角、骶骨倾斜角为(44.4±8.2)°、(36.7±8.5)°、(55.4±13.2)°、(14.4±7.0)°、(42.3±13.1)°,滑脱组骨盆入射角、腰椎前凸角、骨盆倾斜角明显大于对照组(P0.05),而关节突关节角、骶骨倾斜角小于对照组(P0.05)。两组骨盆入射角与骨盆倾斜角、骶骨倾斜角之间有相关性(P0.05),椎间盘退变与关节突关节之间存在相关性(P0.05)。滑脱组L3-S1椎间盘及L_(4,5)关节突关节退变更加严重。结论:腰椎-骨盆结构在退变性腰椎滑脱中发生了明显的变化。腰椎前凸及骨盆后倾现象在腰椎退变性滑脱身体代偿机制中有重要作用,腰椎关节突关节退变与腰椎间盘退变是相互促进的,腰椎滑脱加剧椎间盘与关节突关节退变。     

Orientation and osteoarthritis of the lumbar facet joint

Several studies have shown an association between sagittal orientation of the facet joint and degenerative spondylolisthesis. There is currently no information available on the association between orientation of the facet joint and osteoarthritis. This study examined the association between orientation and osteoarthritis of the lumbar facet joints. One hundred eleven consecutive patients underwent plain radiography and magnetic resonance imaging. These patients were divided into two groups: No Degenerative Spondylolisthesis Group (98 patients) and Degenerative Spondylolisthesis Group (13 patients). In the No Degenerative Spondylolisthesis Group, segments with higher grades of osteoarthritis showed more sagittal orientation of the facetjoints at the L3-L4 and L4-L5 levels. The facet joint was oriented significantly more sagittally in the Degenerative Spondylolisthesis Group than in the No Degenerative Spondylolisthesis Group at the L4-L5 and L5-S1 levels. The severity of facet joint osteoarthritis was significantly higher in the Degenerative Spondylolisthesis Group than in the No Degenerative Spondylolisthesis Group at the L3-L4, L4-L5, and L5-S1 levels. A significant association was found between sagittal orientation and osteoarthritis of the lumbar facet joints, even in patients without degenerative spondylolisthesis. Facet joint osteoarthritis, rather than spondylolisthesis, is the pathoanatomic feature that is associated with sagittal orientation of the facet joints in patients with degenerative spondylolisthesis.     

Age-related changes in axial and sagittal orientation of the facet joints: Comparison with changes in degenerative spondylolisthesis

Background

Despite facet joints being three-dimensional structures, previous computed tomography and magnetic resonance imaging studies have evaluated facet joint orientation in only the axial plane. Facet joint orientation in the sagittal plane has rarely been studied using these imaging techniques. The aim of this study was to elucidate facet joint orientation in both the axial and sagittal planes on computed tomography.

How to stabilize a single level lesion of degenerative lumbar spondylolisthesis

The purpose of this study was to compare the success rate of bony fusion and the clinical results of rigid instrumentation, nonrigid instrumentation, and no instrumentation for a single level lesion for degenerative lumbar spondylolisthesis. Thirty-three patients with degenerative spondylolisthesis of L4 who had undergone posterior decompression and posterolateral fusion with autogenous bone graft that included the facet joints had a single level stabilization with a newly designed syndesmoplasty using Leeds-Keio artificial ligaments (Group Leeds-Keio-nonrigid). Thirty-four patients with degenerative spondylolisthesis of L4 who had the same procedure were stabilized with the Steffee system (Group Steffee-rigid). Thirty-five patients who had the same decompression and bony fusion without instrumentation (Group Noninstrumented) were compared with the former two groups. Clinical results were correlated with the stage of bony fusion. The Steffee system was reliable for stabilizing intervertebral angular instability such as a preoperative intervertebral angle difference of more than 11 degrees in flexion and extension. In the patients who preoperatively had an angle difference of less than 10 degrees, no significant difference was seen between Group Leeds-Keio and Group Steffee. The authors concluded that nonrigid instrumentation can be used to achieve successful bony fusion in patients with degenerative spondylolisthesis, who have a preoperative angle difference less than 10 degrees, with excellent clinical results.     

The significance of facet joint cross-sectional area on magnetic resonance imaging in relationship to cervical degenerative spondylolisthesis

Background contextCharacteristic changes of the facet joints, including synovial cysts, facet joint hypertrophy, and facet joint effusions, on magnetic resonance imaging (MRI) and computed tomography have been associated with lumbar degenerative spondylolisthesis. The cervical facets have not been examined for associations with cervical degenerative spondylolisthesis similar to those seen in the lumbar spine.PurposeTo define abnormalities of the facet joints seen on supine MRI that correlate with cervical spondylolisthesis seen on upright radiographs.Study designRetrospective radiographic review of consecutive patients with a universally applied standard.Patient sampleA total of 204 consecutive patients from a single institution, with both an MRI and upright radiographs, were reviewed.Outcome measuresSagittal plane displacement on upright lateral radiographs was compared with MRI. The total area of the facet joint and the amount of facet joint asymmetry were measured on an axial MRI.MethodsThe data were analyzed to determine a significant association between the cervical degenerative spondylolisthesis and the following: facet joint asymmetry, increased total area of the facet joint, and age.ResultsDegenerative spondylolisthesis was seen in 26 patients at C3–C4 and in 27 patients at C4–C5. Upright radiographs identified significantly more degenerative spondylolisthesis than MRIs at levels C3–C4 and C4–C5, 26 versus 6 (p<.001) at C3–C4 and 27 versus 11 (p<.001) at C4–C5. Patients with degenerative spondylolisthesis were more likely to be older, have a larger total facet area, and more facet asymmetry at C3–C4 and C4–C5 (p<.05).ConclusionsSupine MRIs underestimate sagittal displacement compared with upright lateral radiographs. Asymmetric facet hypertrophy at C3–C4 and C4–C5 is associated with degenerative spondylolisthesis on upright lateral films even in the absence of anterolisthesis on supine MRIs.     

The role and incidence of facet tropism in lumbar spine degenerative disc disease.

The correlation of posterior intervertebral (facet) joint tropism (asymmetry), degenerative facet disease, and intervertebral disc disease was reviewed in a retrospective study of magnetic resonance images of the lumbar spine from 100 patients with complaints of low back pain and sciatica. Of the 27 of 100 (27%) of patients discovered to have disc disease (either herniation of nuclear material or bulge) at the L4-5 level, an approximately equal number had facet tropism (14 of 27) as did not (13 of 27). Of the 27 of 100 (27%) patients noted to have disc disease at the L5-S1 level, slightly more (16 of 21) had facet tropism than did not (11 of 27). Of the 65 of 100 (65%) of patients who had facet degenerative disease at the L4-5 level, an approximately equal number had facet tropism (33 of 65) as did not (32 of 100). At the L5-S1 level there was slightly more of a difference, with 25 of 41 having facet degenerative joint disease and tropism and 16 of 41 without it. This study raises questions as to the significance of facet joint tropism in intervertebral disc disease and degenerative facet joint disease but did show that asymmetry of the posterior intervertebral joint is far more common than previously thought: 50% of patients were found to have asymmetric facets at the L5-S1 level and 42% at the L4-5 level.     

Spondylolisthesis of the thoracic spine. Case report

The thoracic spine is stabilized in the anteroposterior direction by the rib cage and the facet joints. Spondylolisthesis of the thoracic spine is less common than that of the lumbar spine. The authors describe a rare case of thoracic spondylolisthesis in which the patient suffered back pain and myelopathy. The patient was a 44-year-old woman. Plain radiography revealed Grade I T11-12 spondylolisthesis. The pedicle-facet joint angle at T-11 was 118 degrees, greater than that of T-10 or T-12. Postmyelography computerized tomography scanning revealed posterior compression of the dural sac as well as enlargement of and degenerative changes in the facet joint at T-11. Magnetic resonance imaging showed anterior and posterior compression of the spinal cord at the level of the spondylolisthesis. To achieve posterior T10-12 decompression, the surgeons performed a laminectomy and posterolateral fusion in which a pedicle screw fixation system was placed. The patient's back pain disappeared immediately after the operation. The authors conclude that the enlargement of the pedicle-facet joint angle and the degenerative changes of the facet joint caused the thoracolumbar spondylolisthesis.