Facet Joint Morphology and Tropism in Adolescents: Association With Lumbar Disk Herniation and Spondylolysis

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 2024-07, Vol.49 (14), p.1029-1035
• Main Authors: Ishihama, Yoshihiro, Tezuka, Fumitake, Manabe, Hiroaki, Morimoto, Masatoshi, Yamashita, Kazuta, Sakai, Toshinori, Sairyo, Koichi
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Cross-Sectional Studies; Female; Humans; Intervertebral Disc Displacement - diagnostic imaging; Intervertebral Disc Displacement - physiopathology; Low Back Pain - diagnostic imaging; Low Back Pain - physiopathology; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - physiopathology; Male; Spondylolysis - diagnostic imaging; Spondylolysis - physiopathology; Tomography, X-Ray Computed; Tropism; Young Adult; Zygapophyseal Joint - diagnostic imaging; Zygapophyseal Joint - physiopathology
• ISSN: 0362-2436; 1528-1159; 1528-1159
• DOI: 10.1097/BRS.0000000000004818

A cross-sectional and observational study. To investigate the incidence of bidirectional lumbar facet tropism and its relationship with lumbar spine disease in adolescents. There is limited information on facet joint asymmetry in the sagittal plane in adolescents. The orientation of all lumbar facet joints was measured in the bidirectional planes on computed tomographic images for 191 patients with low back pain. The patients were divided into 4 groups according to age (10° in the axial plane and >5° in the sagittal plane. Facet joint orientation was compared among groups using a one-way analysis of variance and Tukey honestly significant difference test or Games-Howell post hoc test and the incidence of facet tropism using the Kruskal-Wallis test with Bonferroni correction. The association of facet tropism with disease was investigated further by analyzing facet joint orientation and the incidence of facet tropism in 116 patients with single-level lumbar disease. Facet tropism was observed in 8.7% of axial views and 7.5% of sagittal views. The incidence of axial facet tropism was significantly higher in male patients aged ≥15 years, especially at L4/5. Facet joint morphology in the axial plane was more coronal at L3/4 and L4/5 in male patients ≥15 years than in those