Evaluation of facet joint arthrosis in stenotic and normal lumbar spines with MRI [Stenotik ve Normal Vertebralarda Faset Eklem Artrozunun MRG ile Degerlendirilmesi]

Aim: To reveal the prevalence of lumbar facet joint arthrosis in normal and stenotic lumbar spines with magnetic resonance imaging. Material and Method: Study group consisted of 30 patients with complaints and findings of lower back pain, neurologic claudicatio and lumbar spinal stenosis detected at L3-4, L4-5 and/or L5-S1 with magnetic resonance imaging (cross section area of the dural sac <100mm2) and control group, 30 patients without complaints and radiologic findings of lumbar spinal stenosis. Both left and right facet joint arthrosis for each vertebral level (L3 to S1) were evaluated on spinal magnetic resonance images obtained with a 1.5 T MR scanner (Achieva; Philips Medical Systems, Eindhoven, The Netherlands). Image analysis was carried out by two (one and five years experienced) radiologists and facet joint arthrosis was graded by using a four point scale. Chi-Square, logistic regretion analysis and T-test were carried out to reveal the prevalence at different lumbar levels in both stenosis and non-stenosis groups. Additionally Kappa was calculated to determine the intra-tester and inter-tester reliability of FJ arthrosis evaluation. Results: The prevalence of FJ arthrosis at L4-5 was significantly higher in stenotic group compared to controls. Also, there was no significant association in the prevalence of arthrosis with regard to side at all levels between stenotic and control group. Discussion: Facet joints are synovial articulations and undergo degenerative changes similar to those of other weight-bearing joints. To the best of our knowledge, this is the first study to describe the prevalence of FJ arthrosis in degenerative lumbar stenosis population, with MRI. Further studies should be conducted in order to evaluate and look up for new treatment strategies regarding to facet joint arthrosis, which has been considered as a potential source of low back pain and disability.