Quantitative Radiological Characteristics of the Facet Joints in Patients with Lumbar Foraminal Stenosis

Abstract

Purpose This study aimed to evaluate the degeneration patterns of the facet joints (FJs) in patients with lumbar foraminal stenosis (LFS) and investigate the correlation between quantitative parameters and FJ osteoarthritis (FJ OA). Patients and Methods A total of 171 patients with LFS at the L4/5 level and 146 control patients were enrolled in this study. The severity of FJ OA was graded according to the Weishaupt classification. The FJ orientation, FJ tropism, superior articular process cross-sectional area (SAPA), and FJ area were measured at the L3/4, L4/5, and L5/S1 spinal levels. Associations among the parameters were assessed using Pearson’s correlation coefficients. Independent sample t -tests and Pearson’s chi-square tests were used for univariate analyses. The association between LFS and the quantitative parameters was also analyzed using multivariate logistic regression models adjusted for age, gender, and body mass index. Results Patients with LFS had more sagittal FJ orientation (37.9 vs 45.0, p < 0.001), more FJ tropism (5.6 vs 3.8, p < 0.001), larger SAPA (129.0 vs 97.8, p < 0.001), and less FJ area (21.7 vs 23.3, p = 0.016). Logistic regression analysis showed that LFS was significantly associated with FJ tropism (odds ratio [OR]: 1.153; p = 0.003) and SAPA (OR: 1.113; p < 0.001). The SAPA showed the largest area under the curve (0.908, 95% confidence interval: 0.875–0.942) for the diagnosis of LFS. The optimal cutoff value was 114.75 mm2 with 85.4% sensitivity and 87.0% specificity. Additionally, a significant correlation was observed between FJ OA and SAPA and FJ area at each studied spinal level. Conclusion This study confirmed that LFS is significantly associated with FJ hypertrophy and tropism. FJ hypertrophy and joint space narrowing correlated with the severity of FJ OA. These results are helpful in understanding the morphology and pathology of FJs.

Correlation between Preoperative MRI Parameters and Oswestry Disability Index in Patients with Lumbar Spinal Stenosis: A Retrospective Study

“…The prevalence of grade III and II facet joint osteoarthritis (FJOA) reflects a significant burden of facet joint degeneration within the studied population. This aligns with the existing literature that posits FJOA as a common radiological finding in individuals with lumbar spinal disorders [22][23][24][25]. FJOA has a major implication in LSS as it impacts the narrowing of either the subarticular recess or the foramen through an osteophyte.…”

Effect of different loads on facet joint motion during lumbar lateral bending in sitting position

“…Leng et al suggested that the asymmetry of the lumbar facet joints is correlated with lumbar spondylolisthesis [23]. Wang et al found a correlation between the asymmetry of the lumbar facet joints and spinal canal stenosis [24]. Kou et al investigated the asymmetry of lumbar facet joint motion during standing and found that the most pronounced asymmetry occurred in the L3-L4 and L5-S1 facet joints [25].…”

Facet joint disorders: from diagnosis to treatment

“…High SAP cross-sectional area values over 110.71 mm 2 were associated with lumbar central canal spinal stenosis [ 32 ]. Patients with lumbar foraminal stenosis revealed more sagittal facet joint orientation, more facet joint tropism, a larger SAP cross-sectional area, and smaller facet joint area [ 33 ]. HSAP commonly occurs at the mid-level of the cervical spine unilaterally, and it develops more frequently in men [ 34 ].…”