Skeletal Radiology

, Volume 40, Issue 1, pp 13–23 | Cite as

The lumbar facet joint: a review of current knowledge: part 1: anatomy, biomechanics, and grading

  • Gerard P. Varlotta
  • Todd R. Lefkowitz
  • Mark Schweitzer
  • Thomas J. Errico
  • Jeffrey Spivak
  • John A. Bendo
  • Leon Rybak
Review Article


We present a two-part review article on the current state of knowledge of lumbar facet joint pathology. This first article discusses the functional anatomy, biomechanics, and radiological grading systems currently in use in clinical practice and academic medicine. Facet joint degeneration is presented within the larger context of degenerative disc disease to enable the reader to better understand the anatomical changes underlying facet-mediated lower back pain. Other less-common, but equally important etiologies of lumbar facet joint degeneration are reviewed. The existing grading systems are discussed with specific reference to the reliability of CT and MR imaging in the diagnosis of lumbar facet osteoarthritis. It is hoped that this discussion will stimulate debate on how best to improve the diagnostic reliability of these tests so as to improve both operative and non-operative treatment outcomes.


Lumbar facet joint Zygapophyseal joint pain Facet-mediated pain Lumbar intra-articular steroid injection Lumbar medial branch block Lumbar medial branch neurotomy 


Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© ISS 2010

Authors and Affiliations

  • Gerard P. Varlotta
    • 1
  • Todd R. Lefkowitz
    • 1
  • Mark Schweitzer
    • 2
  • Thomas J. Errico
    • 3
  • Jeffrey Spivak
    • 4
  • John A. Bendo
    • 4
  • Leon Rybak
    • 4
  1. 1.NYU School of MedicineRusk Institute of Rehabilitation MedicineNew YorkUSA
  2. 2.The Ottawa HospitalThe University of OttawaOttawaCanada
  3. 3.NYU School of MedicineNew YorkUSA
  4. 4.NYU School of MedicineNew YorkUSA

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