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Age- and sex-related changes in facet orientation and tropism in lower lumbar spine: an MRI study of 600 patients

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Abstract

Purpose

We aimed to determine the age- and sex-related changes in facet orientation and facet tropism in lower lumbar spine.

Methods

Between June 2015 and December 2017, magnetic resonance imaging scans of the consecutive 600 patients performed in the outpatient department for low back pain were analyzed. The data were divided according to age into four groups: group A (< 30 years), group B (31–45 years), group C (46–60 years) and group D (> 60 years). The orientation of the facet angles at L3–4, L4–5 and L5–S1 was measured using the method described by Noren et al. Sagittal angles and tropism were determined at each level.

Results

Average facet angle is noted to increase from L3–4 to L5–S1 level in all groups irrespective of age and sex. A positive correlation is noted between age and sagittal facet orientation at all levels across all groups. Tropism was noted to be statistically significant (p < 0.05) at L5–S1 level. L3–4 and L4–5 levels did not show a positive correlation with respect to age. Facet angle sagittalization was significantly associated in males at L5–S1 level (p < 0.05) and in females at L4–5 level (p < 0.05).

Conclusions

Predominant morphological changes in superior articular process are responsible for remodeling of facets that occur with increasing age, resulting in sagittalization. Even though the facet orientation changes over a period of time, differential changes within the facets at the same level might not be seen.

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References

  1. Farfan HF, Sullivan JD (1987) The relation of facet orientation to intervertebral disc failure. Can J Surg 10:179–185

    Google Scholar 

  2. Cyron BM, Hutton WC (1980) Articular tropism and stability of the lumbar spine. Spine 5:168–172

    Article  CAS  PubMed  Google Scholar 

  3. Boden SD, Riew KD, Yamaguchi K, Branch TP, Wiesel SW (1996) Orientation of the lumbar facet joints: association with degenerative disc disease. J Bone Joint Surg Am 78:403–411

    Article  CAS  PubMed  Google Scholar 

  4. Grobler LJ, Robertson PA, Novotny JE, Pope MM (1993) Etiology of spondylolisthesis: assessment of the role played by lumbar facet joint morphology. Spine 18:80–91

    Article  CAS  PubMed  Google Scholar 

  5. Kim NH, Lee JW (1995) The relationship between isthmic and degenerative spondylolisthesis and the configuration of the lamina and facet joints. Eur Spine J 4:139–144

    Article  CAS  PubMed  Google Scholar 

  6. Grannum S et al (2015) Risk factors for the development of a mobile degenerative spondylolisthesis at L4–L5. Spine Deform 3:98–104

    Article  CAS  PubMed  Google Scholar 

  7. Noren R, Trafimow J, Andersson GB, Huckman MS (1991) The role of facet joint tropism and facet angle in disc degeneration. Spine 16:530–532

    Article  CAS  PubMed  Google Scholar 

  8. Chadha M et al (2013) Association of facet tropism with lumbar disc herniation. Eur Spine J 22:1045–1052

    Article  PubMed  Google Scholar 

  9. Samartzis D, Cheung JP et al (2016) Critical values of facet joint angulation and tropism in the development of lumbar degenerative spondylolisthesis: an international, large-scale multicenter study by the AO Spine Asia Pacific research collaboration consortium. Glob Spine J 5:414–421

    Article  Google Scholar 

  10. Boos N, Weissbach S, Rohrbach H et al (2002) Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo award in basic science. Spine 27:2631–2644

    Article  PubMed  Google Scholar 

  11. Vanharanta H, Floyd T, Ohnmeiss DD, Hochschuler SH, Guyer RD (1993) The relationship of facet tropism to degenerative disc disease. Spine 18:1000–1005

    Article  CAS  PubMed  Google Scholar 

  12. Adams MA, Hutton WC (1981) The relevance of torsion to the mechanical derangement of the lumbar spine. Spine 6:241–248

    Article  CAS  PubMed  Google Scholar 

  13. Lorenz M, Patwardhan A, Vanderby R Jr (1983) Load-bearing characteristics of lumbar facets in normal and surgically altered spinal segments. Spine (Phila Pa 1976) 8:122–130

    Article  CAS  Google Scholar 

  14. Yang KH, King AI (1984) Mechanism of facet load transmission as a hypothesis for low-back pain. Spine (Phila Pa 1976) 9:557–565

    Article  CAS  Google Scholar 

  15. Van Schaik JP, Verbiest H, Van Schaik FD (1985) The orientation of laminae and facet joints in the lower lumbar spine. Spine 10(1):59–63

    Article  PubMed  Google Scholar 

  16. Dunlop RB, Adams MA, Hutton WC (1984) Disc space narrowing and the lumbar facet joints. J Bone Joint Surg Br 66:706–710

    Article  CAS  PubMed  Google Scholar 

  17. Benoist M (2003) Natural history of the aging spine. Eur Spine J 12(suppl 2):S86–S89

    Article  PubMed  PubMed Central  Google Scholar 

  18. Ingalhalikar VT (2003) Understanding spinal instability. Indian J Orthop 37:2

    Google Scholar 

  19. Jaumard NV, Welch WC, Winkelstein BA (2011) Spinal facet joint biomechanics and mechano transduction in normal, injury and degenerative conditions. J Biomech Eng 133:071010-1

    Google Scholar 

  20. Fujiwara A, Tamai K, An HS et al (2001) Orientation and osteoarthritis of the lumbar facet joint. Clin Orthop Relat Res 385:88–94

    Article  Google Scholar 

  21. Wang J, Yang X (2009) Age-related changes in the orientation of lumbar facet joints. Spine 34(17):596–598

    Article  Google Scholar 

  22. Love TW, Fagan AB, Fraser RD (1999) Degenerative spondylolisthesis. Developmental or acquired? J Bone Joint Surg Br 81:670–674

    Article  CAS  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Stavya Spine Hospital and Research Institute Pvt. Ltd, Mithakali, Ahmedabad, India

    Devanand Degulmadi, Bharat R. Dave & Ajay Krishnan

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  1. Devanand Degulmadi
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  2. Bharat R. Dave
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  3. Ajay Krishnan
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Correspondence to Devanand Degulmadi.

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Degulmadi, D., Dave, B.R. & Krishnan, A. Age- and sex-related changes in facet orientation and tropism in lower lumbar spine: an MRI study of 600 patients. Eur Spine J 28, 961–966 (2019). https://doi.org/10.1007/s00586-019-05953-y

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