Surgical and Radiologic Anatomy

, Volume 40, Issue 9, pp 1063–1075 | Cite as

Evaluation of the facet joints with magnetic resonance images in the patients with disc degeneration and spondylolisthesis

  • Yunus Emre Kundakci
  • Nadire Unver DoganEmail author
  • Ibrahim Guler
  • Ismihan Ilknur Uysal
  • Zeliha Fazliogullari
  • Ahmet Kagan Karabulut
Original Article



We aimed to research in detail the morphology of the facet orientation (FO) and tropism (FT) in degenerative diseases.


This study consisted of patients with disc degeneration (DD) and with lumbar spondylolisthesis (LS) as well as a control group without these two diseases. The group of patients with DD was separated by DD grades. Vertebral body and intervertebral discs’ (IVDs) morphometric values, facet joint osteoarthritis (OA) grading, FO and FT were examined in all the groups. All measurements were applied to MRIs of 353 patients.


There was a significant difference in facet angle values between the groups at L4–L5 (FO: p = 0.001). There was a significant negative correlation between FO at L4–L5 and L4 vertebral body anterior posterior diameter and L5 mid-vertebral body height, in 353 patients (p = 0.003; p = 0.010). Facet joint OA grading scores were lower in the control group than in the disc degeneration patient (DDP) and LS groups (p < 0.05). Sagittal FO was seen with the increase of facet joint OA scores at L4–L5 in the control and DDP groups (control: p = 0.001; DDP: p = 0.40).


Facet joints can show different orientation values in LS and DDP groups at L4–L5. The presence of FT is a risk factor for an LS patient at L4–L5. Sagittal FO is seen with vertebral slip at L5–S1. FO is affected by the morphometric changes of the vertebral body at L4–L5. Discussions in this regard need to be resolved through further research.


Degenerative spine Facet angle Lumbar intervertebral disc Vertebra morphometry Spondylolisthesis 


  1. 1.
    Abbas J, Hamoud K, May H, Hay O, Medlej B, Masharawi Y, Peled N, Hershkovitz I (2010) Degenerative lumbar spinal stenosis and lumbar spine configuration. Eur Spine J 19:1865–1873CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Adams MA, Hutton WC (1983) The mechanical function of the lumbar apophyseal joints. Spine 8:327–330CrossRefPubMedGoogle Scholar
  3. 3.
    Amonoo-Kuofi HS (1991) Morphometric changes in the heights and anteroposterior diameters of the lumbar intervertebral discs with age. J Anat 175:159PubMedPubMedCentralGoogle Scholar
  4. 4.
    Berlemann U, Jeszenszky DJ, Bühler DW, Harms J (1998) Facet joint remodeling in degenerative spondylolisthesis, an investigation of joint orientation and tropism. Eur Spine J 7:376–380CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Boden SD, Riew KD, Yamaguchi K, Branch TP, Schellinger S, Wiesel SW (1996) Orientation of the lumbar facet joints, association with degenerative disc disease. J Bone Joint Surg 78:403–411CrossRefPubMedGoogle Scholar
  6. 6.
    Dai LY (2001) Orientation and tropism of lumbar facet joints in degenerative spondylolisthesis. Int Orthop 25:40–42CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Do DH, Taghavi CE, Fong W, Kong MH, Morishita Y, Wang JC (2011) The relationship between degree of facet tropism and amount of dynamic disc bulge in lumbar spine of patients symptomatic for low back pain. Eur Spine J 20:71–78CrossRefPubMedGoogle Scholar
  8. 8.
    Don AS, Robertson PA (2008) Facet joint orientation in spondylolysis and isthmic spondylolisthesis. J Spinal Disord Tech 21:112–115CrossRefPubMedGoogle Scholar
  9. 9.
    Fujiwara A, Lim TH, An HS, Tanaka N, Jeon CH, Andersson GB, Haughton VM (2000) The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine 25:3036–3044CrossRefPubMedGoogle Scholar
  10. 10.
    Fujiwara A, Tamai K, An HS, Lim TH, Yoshida H, Kurihashi A, Saotome K (2001) Orientation and osteoarthritis of the lumbar facet joint. Clin Orthop Relat Res 385:88–94CrossRefGoogle Scholar
  11. 11.
    Gocmen-Mas N, Karabekir H, Ertekin T, Edizer M, Canan Y, Duyar I (2010) Evaluation of lumbar vertebral body and disc: a stereological morphometric study. Int J Morphol 28:841–847CrossRefGoogle Scholar
  12. 12.
    Grobler LJ, Robertson PA, Novotny JE, Pope MH (1993) Etiology of spondylolisthesis, assessment of the role played by lumbar facet joint morphology. Spine 18:80–91CrossRefPubMedGoogle Scholar
  13. 13.
    Grogan J, Nowicki BH, Schmidt TA, Haughton VM (1997) Lumbar facet joint tropism does not accelerate degeneration of the facet joints. Am J Neuroradiol 18:1325–1329PubMedGoogle Scholar
  14. 14.
    Jentzsch T, Geiger J, Zimmermann SM, Slankamenac K, Nguyen-Kim TDL, Werner CM (2013) Lumbar facet joint arthritis is associated with more coronal orientation of the facet joints at the upper lumbar spine. Radiol Res Pract 2013:693971PubMedPubMedCentralGoogle Scholar
  15. 15.
    Kalichman L, Suri P, Guermazi A, Li L, Hunter DJ (2009) Facet orientation and tropism, associations with facet joint osteoarthritis and degenerative spondylolisthesis. Spine 34:E579CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Karacan I, Aydin T, Sahin Z, Cidem M, Koyuncu H, Aktas I, Uludag M (2004) Facet angles in lumbar disc herniation: their relation to anthropometric features. Spine 29:1132–1136CrossRefPubMedGoogle Scholar
  17. 17.
    Kim KH, Park JY, Kuh SU, Chin DK, Kim KS, Cho YE (2013) Changes in spinal canal diameter and vertebral body height with age. Yonsei Med J 54:1498–1504CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Kirkaldy-Willis WH, Wedge JH, Yong-Hing K, Reilly J (1978) Pathology and pathogenesis of lumbar spondylosis and stenosis. Spine (Phila Pa 1976) 3:319–328CrossRefGoogle Scholar
  19. 19.
    Kong MH, He W, Tsai YD, Chen NF, Keorochana G, Do DH, Wang JC (2009) Relationship of facet tropism with degeneration and stability of functional spinal unit. Yonsei Med J 50:624–629CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Lee DY, Lee SH (2009) Effects of facet tropism and disk degeneration on far lateral lumbar disk herniation: comparison with posterolateral lumbar disk herniation. Neurologia Medico-chirurgica 49:57–61CrossRefPubMedGoogle Scholar
  21. 21.
    Malkoc I, Aydinlioglu SA et al (2012) Age related changes in height and shape of the lumbar intervertebral discus. Eur J Basic Med Sci 2:68–73Google Scholar
  22. 22.
    Meyerding HW (1932) Spondylolisthesis. Surg Gynecol Obstet 54:371–377Google Scholar
  23. 23.
    Nguyen HS, Doan N et al (2016) Upright magnetic resonance imaging of the lumbar spine: Back pain and radiculopathy. J Cranioverteb Junction Spine 7:31CrossRefGoogle Scholar
  24. 24.
    Noren R, Trafimow J, Andersson GB, Huckman MS (1991) The role of facet joint tropism and facet angle in disc degeneration. Spine 16:530–532CrossRefPubMedGoogle Scholar
  25. 25.
    Pfirrmann CW, Metzdorf A, Zanetti M et al (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26:1873–1878CrossRefPubMedGoogle Scholar
  26. 26.
    Pichaisak W, Chotiyarnwong C, Chotiyarnwong P (2015) Facet joint orientation and tropism in lumbar degenerative disc disease and spondylolisthesis. J Med Assoc Thai 98:373–379PubMedGoogle Scholar
  27. 27.
    Roberts N, Gratin C, Whitehouse GH (1997) MRI analysis of lumbar intervertebral disc height in young and older populations. J Magn Reson Imaging 7:880–886CrossRefPubMedGoogle Scholar
  28. 28.
    Samartzis D, Cheung JPY et al (2016) Critical values of facet joint angulation and tropism in the development of lumbar degenerative spondylolisthesis: an international, large-scale multicenter study by the AOSpine Asia Pacific Research Collaboration Consortium. Glob Spine J 6:414–421CrossRefGoogle Scholar
  29. 29.
    Takashima H, Takebayash T, Yoshimoto M et al (2014) Investigation of intervertebral disc and facet joint in lumbar spondylolisthesis using T2 mapping. Magn Reson Med Sci 13:261–266CrossRefPubMedGoogle Scholar
  30. 30.
    Weishaupt D, Schweitzer ME, Alam F et al (1999) MR imaging of inflammatory joint diseases of the foot and ankle. Skelet Radiol 28:663–669CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Yunus Emre Kundakci
    • 1
  • Nadire Unver Dogan
    • 1
    Email author
  • Ibrahim Guler
    • 2
  • Ismihan Ilknur Uysal
    • 3
  • Zeliha Fazliogullari
    • 1
  • Ahmet Kagan Karabulut
    • 1
  1. 1.Department of AnatomySelcuk University, Medical FacultyKonyaTurkey
  2. 2.KonyaTurkey
  3. 3.Department of AnatomySelcuk University, Meram Medical FacultyKonyaTurkey

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