Abstract
With CT imaging, the lumbar facet joints are well visualised and enlargement secondary to degeneration may be noted. We measured the cross-sectional area of the superior articular process of the L5 facet joint in 100 consecutive CT scans and in 71 patients, the L4 process was also measured. We found that the mean cross-sectional area was significantly larger at L5 than at L4. Patient age and sex had no significant effect on the size at either L4 or L5. A review of the radiological reports revealed that the 13 patients with degenerative facet joints and radiologically normal discs did not have significantly larger facet joints than the 35 patients with disc disease and radiologically normal facet joints. In conclusion, the term “facet joint hypertrophy” should not be used when osteoarthritic changes are noted on CT scan, because these joints are not significantly larger than normal facet joints.
Key words: Degeneration, Facet joint, Anatomy, Lumbar spine, CT
Full Text
The Full Text of this article is available as a PDF (313.1 KB).
References
- 1.Carrera GF, Haughton VM, Syvertsen A, Williams A. Computed tomography of the lumbar facet joints. Radiology. 1980;134:145–148. doi: 10.1148/radiology.134.1.7350594. [DOI] [PubMed] [Google Scholar]
- 2.Cassidy JD, Loback D, Yong-Hing K, Tchang S. Lumbar facet joint asymmetry. Spine. 1992;17:570–574. [PubMed] [Google Scholar]
- 3.Fang D, Cheung KMC, Ruan D, Chan FL. Computed tomography osteometry of the Asian lumbar spine. J Spinal Disord. 1994;7:307–316. [PubMed] [Google Scholar]
- 4.Grobler LJ, Robertson PA, Novotney JE, Pope MH. Etiology of spondylolisthesis. Assessment of the role played by lumbar facet joint morphology. Spine. 1993;18:80–91. [PubMed] [Google Scholar]
- 5.Haughton VM, Williams AL. Computed tomography of the spine. St Louis: Mosby; 1982. [Google Scholar]
- 6.Lewin T. Osteoarthritis in lumbar synovial joints. A morphological study. Acta Orthop Scand [Suppl] 1964;73:1–112. doi: 10.3109/ort.1964.35.suppl-73.01. [DOI] [PubMed] [Google Scholar]
- 7.Noren R, Trafimow J, Andersson GB, Huckman MS. The role of facet joint tropism and facet angle in disc degeneration. Spine. 1991;16:530–532. doi: 10.1097/00007632-199105000-00008. [DOI] [PubMed] [Google Scholar]
- 8.Panjabi MM, Oxland T, Takata K, Goel V, Duranceau J, Krag M. Articular facets of the human spine. Quantitative three dimensional anatomy. Spine. 1993;18:1298–1310. doi: 10.1097/00007632-199308000-00009. [DOI] [PubMed] [Google Scholar]
- 9.Postachini F. Management of lumbar spinal stenosis. J Bone Joint Surg [Br] 1996;78:154–164. [PubMed] [Google Scholar]
- 10.Schaik JP, Verbiest H, Schaik FD. The orientation of laminae and facet joints in the lower lumbar spine. Spine. 1985;10:59–63. doi: 10.1097/00007632-198501000-00009. [DOI] [PubMed] [Google Scholar]