By Ismail Jatoi, Manfred Kaufmann, Jean-Yves Petit

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The arrow points to the remnants of the joint space. This type of change occurs when there has been immobilization of the joint for prolonged periods. 15 Degeneration and subluxation of the posterior joint Light microscopic cross-sectional view of a degenerated posterior joint. The two surfaces of the articular cartilage have slid past each other, resulting in subluxation of the joint. On the left side, a fibrofatty tag of synovium attached to the joint capsule extends into the joint (arrow). 16 Degeneration with hypertrophy of the posterior joint Light microscopic cross-sectional view of a posterior joint showing extensive hypertrophy and enlargement of the bones of the facets.

With immobilization, the posterior muscles are gradually replaced by fibrofatty tissue which increases with prolonged periods of inactivity. ©2002 CRC Press LLC BIBLIOGRAPHY Cooper RR. Alterations during immobilization and regeneration of skeletal muscle. J Bone Joint Surg 1972;54A:919 Kirkaldy-Willis WH, McIvor GWD. Spinal Stenosis. Clinical Orthopaedics and Related Research. 1 Spondylolysis Traumatic, congenital and degenerative changes can all result in deformity of spinal structures. Many of these abnormalities are of no clinical consequence, but under certain circumstances can predispose a patient to increasing pain.

Intrathecally enhanced axial computed tomogram reveals central canal stenosis secondary to posterior facet joint hypertrophy and vertebral body osteophyte formation and disc bulging (c). Sagittal proton density MR image (d) demonstrates multiple level spondylotic changes and central canal stenosis at L2–L3 and L3–L4. 0 1µV 20ms Somatosensory evoked responses from the posterior tibial and pudendal nerves are blocked as they travel through the spinal cord. The reflex studies from the bulbocavernosus and urethra to the rectal sphincter are intact below the level of the injury.

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