The relationship between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI study

The role of MRI in assessing facet joint osteoarthritis is unclear. By developing a grading system for severity of facet joint osteoarthritis on MRI, the relationship between disc degeneration and facet joint osteoarthritis was determined. The accuracy of MRI in assessing facet joint osteoarthritis against CT was 94%. Under 40 years of age, the degree of disc degeneration varied among individuals. Over the age of 60, most of the discs were markedly degenerated. Under 40 years of age osteoarthritic changes in facet joints were minimal. Over the age of 60, variable degrees of facet joint osteoarthritis were observed but some facets did not show osteoarthritis. No facet joint osteoarthritis was found in the absence of disc degeneration and most facet joint osteoarthritis appeared at the intervertebral levels with advanced disc degeneration. Disc degeneration is more closely associated with aging than with facet joint osteoarthritis. The present study supports the hypothesis that “disc degeneration precedes facet joint osteoarthritis”, and also supports the concept that it may take 20 or more years to develop facet joint osteoarthritis following the onset of disc degeneration.

[1]  C. Hirsh,et al.  The anatomical basis for low back pain , 1963 .

[2]  M. Modic,et al.  Magnetic resonance imaging of intervertebral disk disease. Clinical and pulse sequence considerations. , 1984, Radiology.

[3]  B. Vernon‐roberts,et al.  Degenerative changes in the intervertebral discs of the lumbar spine and their sequelae. , 1977, Rheumatology and rehabilitation.

[4]  H Y Kressel,et al.  Normal and degenerative posterior spinal structures: MR imaging. , 1987, Radiology.

[5]  D Resnick,et al.  Osteoarthritis of the facet joints: accuracy of oblique radiographic assessment. , 1987, Radiology.

[6]  T Videman,et al.  Magnetic Resonance Imaging Findings and Their Relationships in the Thoracic and Lumbar Spine: Insights Into the Etiopathogenesis of Spinal Degeneration , 1995, Spine.

[7]  T Videman,et al.  The Value of the Axial View in Assessing Discograms An Experimental Study with Cadavers , 1987, Spine.

[8]  Nicholas,et al.  Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. , 1990, The Journal of bone and joint surgery. American volume.

[9]  M. B. Coventry,et al.  THE INTERVERTEBRAL DISC: ITS MICROSCOPIC ANATOMY AND PATHOLOGY , 1945 .

[10]  B. Vernon‐roberts,et al.  Osteoarthrosis of the facet joints resulting from anular rim lesions in sheep lumbar discs. , 1999, Spine.

[11]  H. Farfan,et al.  Lumbar intervertebral disc degeneration: the influence of geometrical features on the pattern of disc degeneration--a post mortem study. , 1972, The Journal of bone and joint surgery. American volume.

[12]  W. Hutton,et al.  Articular Tropism and Stability of the Lumbar Spine , 1980, Spine.

[13]  M. C. Powell,et al.  PREVALENCE OF LUMBAR DISC DEGENERATION OBSERVED BY MAGNETIC RESONANCE IN SYMPTOMLESS WOMEN , 1986, The Lancet.

[14]  M. Panjabi,et al.  Effects of Disc Injury on Mechanical Behavior of the Human Spine , 1984, Spine.

[15]  T. Oegema,et al.  Facet Joint Changes After Chemonucleolysis-induced Disc Space Narrowing , 1986, Spine.

[16]  J. Kellgren,et al.  Osteo-arthrosis and Disk Degeneration in an Urban Population * , 1958, Annals of the rheumatic diseases.

[17]  Daniel R. Benson,et al.  New Perspectives on Low Back Pain. , 1990 .

[18]  Bradford Ds,et al.  The inter-relationship of facet joint osteoarthritis and degenerative disc disease. , 1991 .

[19]  H. Farfan,et al.  Instability of the lumbar spine. , 1982, Clinical orthopaedics and related research.

[20]  L. Giles,et al.  Lumbo-sacral zygapophyseal joint tropism and its effect on hyaline cartilage. , 1987, Clinical biomechanics.

[21]  T. Lewin,et al.  OSTEOARTHRITIS IN LUMBAR SYNOVIAL JOINTS. A MORPHOLOGIC STUDY. , 1964, Acta orthopaedica Scandinavica. Supplementum.

[22]  C. Seibert,et al.  A Cross-Sectional Prevalence Study of Lumbar Disc Degeneration in a Working Population , 1989, Spine.

[23]  A. Schultz,et al.  Lumbar Disc Degeneration: Correlation with Age, Sex, and Spine Level in 600 Autopsy Specimens , 1988, Spine.

[24]  H. Muir,et al.  Experimental intervertebral disc degeneration: morphologic and proteoglycan changes over time. , 1981, Arthritis and rheumatism.

[25]  H. Nathan,et al.  Osteophytes of the Vertebral Column , 1962 .

[26]  J. Lawrence.  Disc degeneration. Its frequency and relationship to symptoms. , 1969, Annals of the rheumatic diseases.

[27]  G. Andersson,et al.  Discs Degenerate Before Facets , 1990, Spine.

[28]  L. Twomey,et al.  Age changes in the lumbar articular triad. , 1985, The Australian journal of physiotherapy.

[29]  J L Kelsey,et al.  Epidemiology and Impact of Low-Back Pain , 1980, Spine.

[30]  T. Ducker,et al.  Magnetic resonance assessment of the distribution of lumbar spine disc degenerative changes. , 1988, Journal of spinal disorders.

[31]  G. Andersson,et al.  The Role of Facet Joint Tropism and Facet Angle in Disc Degeneration , 1991, Spine.

[32]  D G Wilder,et al.  Spine radiographs in patients with low-back pain. An epidemiological study in men. , 1984, The Journal of bone and joint surgery. American volume.

[33]  H K Genant,et al.  Computed tomography of the lumbar spine. , 1983, The Orthopedic clinics of North America.

[34]  W C Hutton,et al.  Disc space narrowing and the lumbar facet joints. , 1984, The Journal of bone and joint surgery. British volume.