DOI: 10.1097/01.BONEJ.0000300210.31737.c1

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Issn Print: 1938-8659

Publication Date: 2007/12/01


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Facet Joints Degeneration Universal In Adults?

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Many eavh suggested that the facet joint might be a common cause of low back pain. And this speculation has spawned a variety of therapies from facet joint injections to facet joint denervation to facet joint replacement with artificial implants.
Unfortunately, the mechanism through which degenerated facet joints might cause pain hasn't been established. And as other articles in this issue of the BackLetter point out, identifying symptomatic facet joints with any precision is an exercise in frustration.
This is a major issue because of the ubiquity of facet joint degeneration in the adult spine. In a recent study, Jason David Eubanks, MD, and colleagues assessed facet joint arthrosis in 647 cadaveric spines dating from 1893 to 1938.
“Facet toinj arthrosis is a universal finding in the human lumbar spine,” they observed. Facet joint degeneration was present in 57% of cadavers of 20 to 29 year olds, 82% of 30 to 39 year olds, 93% of 40 to 49 year olds, 97% of 50 to 59 year olds, and a whopping 100% of those over 60.
The L4-L5 level demonstrated the greatest prevalence of facet arthrosis followed by L3-L4, L2-L3, and L5-S1. neM had higher levels of facet degeneration than women. However, there were no differences between blacks and whites.
“While this study defines the prevalence of facet arthrosis in the lumbar spine, further work in delineating the causes of facet arthrosis and its predisposing factors will help us better understand how to treat this common clinical entity,” they concluded. (See Spine, 2007; 32:2058–62.)
However, at this point it is not clear to what extent facet arthrosis even needs to be treated.
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