Prevalence of lumbar facet arthrosis and its relationship to age, sex, and race : An anatomic study of cadaveric specimens

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 2007-09, Vol.32 (19), p.2058-2062
• Main Authors: EUBANKS, Jason David, LEE, Michael J, CASSINELLI, Ezequiel, AHN, Nicholas U
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; African Continental Ancestry Group - statistics & numerical data; Age Distribution; Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Cadaver; Cerebrospinal fluid. Meninges. Spinal cord; Diseases of the osteoarticular system; Diseases of the spine; European Continental Ancestry Group - statistics & numerical data; Female; Humans; Low Back Pain - epidemiology; Low Back Pain - ethnology; Low Back Pain - etiology; Low Back Pain - pathology; Lumbar Vertebrae - pathology; Male; Medical sciences; Middle Aged; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Nervous system (semeiology, syndromes); Neurology; Osteoarthritis - complications; Osteoarthritis - epidemiology; Osteoarthritis - ethnology; Osteoarthritis - etiology; Osteoarthritis - pathology; Prevalence; Risk Assessment; Risk Factors; Severity of Illness Index; Sex Factors; Zygapophyseal Joint - pathology
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/BRS.0b013e318145a3a9

An anatomic, epidemiologic study of facet arthrosis in cadaveric lumbar spines. To define the prevalence of lumbar facet arthrosis in a large population sample and to examine its association with age, sex, and race. Arthrosis of lumbar facet joints is a common radiographic finding and has been linked to low back pain. However, no population studies have specifically defined the prevalence of facet arthrosis in the lumbar spine in relation to age, sex, and race. A total of 647 cadaveric lumbar spines were examined by a single examiner for evidence of lumbar facet arthrosis. Information on race, age, and sex were collected. Arthrosis at each facet was graded from 0 to 4 on a continuum from no arthritis to complete ankylosis. Facet arthrosis was present in 53% (L1-L2), 66% (L2-L3), 72% (L3-L4), 79% (L4-L5), and 59% (L5-S1). By decade, facet arthrosis was present in 57% of 20- to 29-year-olds, 82% of 30- to 39-year-olds, 93% of 40- to 49-year-olds, 97% in 50- to 59-year-olds, and 100% in those >60 years old. Fisher exact test and t test demonstrated that men had a greater prevalence and degree of facet arthrosis than women at all lumbar levels (P < 0.001). The lumbar level with the highest prevalence and degree of arthrosis was the L4-L5 level, as compared with each of the other levels (P < 0.001). There was no difference in arthrosis between right versus left facet joints (P > 0.5). Facet arthrosis is a universal finding in the human lumbar spine. Evidence of arthrosis begins early, with more than one half of adults younger than 30 years demonstrating arthritic changes in the facets. The most common arthritic level appears to be L4-L5. Men have a higher prevalence and degree of facet arthrosis than women.