Journal of Orthopedics and Joint Surgery

Register      Login

VOLUME 3 , ISSUE 1 ( January-June, 2021 ) > List of Articles

Original Article

Prevalence of Facet Tropism in Lumbar Spine among South Indian Population: An MRI-based Radiological Study in 400 Patients

Saikrishna Gadde, Sudhir Ganesan, Vignesh Jeyabalan, Karthik K Kannan, Venkatesh Kumar

Citation Information : Gadde S, Ganesan S, Jeyabalan V, Kannan KK, Kumar V. Prevalence of Facet Tropism in Lumbar Spine among South Indian Population: An MRI-based Radiological Study in 400 Patients. 2021; 3 (1):36-40.

DOI: 10.5005/jp-journals-10079-1038

License: CC BY-NC 4.0

Published Online: 07-07-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Background: Facet tropism (FT) is the presence of asymmetry in the sagittal angulations of the bilateral facet joints, which is proposed to be a contributing factor for certain spinal disorders. Few studies are present in literature discussing the prevalence of FT in the lumbar spine among the South Indian population and our study shall focus on this by identifying it on MR imaging. Materials and methods: It is a cross-sectional study, where 400 lumbar MRI scans of patients with low back pain without trauma, deformities, and surgical history were studied between 2016 and 2019. Facet angles are measured and the presence of FT and its severity is assessed on axial sections in all the patients. Data is subjected to statistical analysis. Results: One hundred and eighty-two (45.5%) females and 218 (54.5%) males are included in this study. The age range is 26–86 years and the mean ages of the female and male samples are 52.89 ± 14.06 and 52.31 ± 13.62 years. Facet tropism is seen in 178 (44.6%) individuals and is noticed at all levels from L1 to S1. The presence of FT is 2% at L1-L2, 12.9% at L2-L3, 13.9% at L3-L4, 28.7% at L4-L5, and 21.8% at L5-S1. The degree of tropism was severe at the L4-L5 intervertebral level in 5.9% of the study population. Age and gender do not have a significant correlation with the presence of tropism. All the above results have attained statistical significance. Conclusion: The presence of FT is not uncommon, although its incidence varies at each level of the lumbar spine. The prevalence of FT in our study population is 44.6%. The highest prevalence of FT and a severe degree of FT were noticed in the L4-L5 level.

  1. Lorenz M, Patwardhan A, Vanderby R. Load-bearing characteristics of lumbar facets in normal and surgically altered spinal segments. Spine (Phila Pa 1976) 1983;8(2):122–130. DOI: 10.1097/00007632-198303000-00002.
  2. Yang KH, King AI. Mechanism of facet load transmission as a hypothesis for low-back pain. Spine (Phila Pa 1976) 1984;9(6):557–565. DOI: 10.1097/00007632-198409000-00005.
  3. Hamill J, Knutzen KM. Biomechanical basis of human movement. 3rd ed., USA: Lippincott Williams & Wilkins; 2009. p. 248.
  4. Cyron BM, Hutton WC. Articular tropism and stability of the lumbar spine. Spine (Phila Pa 1976) 1980;5(2):168–172. DOI: 10.1097/00007632-198003000-00011.
  5. Ghandhari H, Ameri E, Hasani H. Is facet tropism associated with increased risk of disc herniation in the lumbar spine? Asian Spine J 2018;12(3):428–433. DOI: 10.4184/asj.2018.12.3.428.
  6. Boden SD, Riew KD. Orientation of the lumbar facet joints: association with degenerative disc disease. J Bone Joint Surg Am 1996;78(3):403–411. DOI: 10.2106/00004623-199603000-00012.
  7. Karacan I, Aydin T, Sahin Z, et al. Facet angles in lumbar disc herniation: their relation to anthropometric features. Spine. 2004;29(10):1132–1136. DOI: 10.1097/00007632-200405150-00016.
  8. Ko S, Chae S, Choi W, et al. The prevalence of facet tropism and its correlation with low back pain in selected community-based populations. Clin Orthop Surg 2019;11(2):176–182. DOI: 10.4055/cios.2019.11.2.176.
  9. Mohanty SP, Pai Kanhangad M, Kamath S, et al. Morphometric study of the orientation of lumbar zygapophyseal joints in a South Indian population. J Orthop Surg (Hong Kong) 2017;25(3):2309499017739483. DOI: 10.1177/2309499017739483.
  10. Grogan J, Nowicki BH, Schmidt TA, et al. Lumbar facet joint tropism does not accelerate degeneration of the facet joints. AJNR Am J Neuroradiol 1997;18(7):1325–1329.
  11. Kong MH, He W, Tsai YD, et al. Relationship of facet tropism with degeneration and stability of functional spinal unit. Yonsei Med J 2009;50(5):624–629. DOI: 10.3349/ymj.2009.50. 5.624.
  12. Noren R, Trafimow J, Andersson GB. The role of facet joint tropism and facet angle in disc degeneration. Spine 1991;16(5):530–532. DOI: 10.1097/00007632-199105000-00008.
  13. Kalichman L, Suri P, Guermazi A. Facet orientation and tropism: associations with facet joint osteoarthritis and degeneratives. Spine (Phila Pa 1976) 2009;34(16):E579–E585. DOI: 10.1097/BRS.0b013e3181aa2acb.
  14. Samartzis D, Cheung JP, Rajasekaran S. 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. Global Spine J 2016;6(05):414–421. DOI: 10.1055/s-0035-1564417.
  15. Samartzis D, Cheung JPY, Rajasekaran S, et al. Is lumbar facet joint tropism developmental or secondary to degeneration? an international, large-scale multicenter study by the AOSpine Asia Pacific research collaboration consortium. Scoliosis 2016;11(1):9. DOI: 10.1186/s13013-016-0062-2.
  16. Arzpeyma SF, Hajir P, Khorram PB. The relationship between facet tropism and lumbar disc herniation in patients with low back pain. AIMS Med Sci 6(3):181–190. DOI: 10.3934/medsci.2019.3.181.
  17. Love TW, Fagan AB, Fraser RD. Degenerative spondylolisthesis. Developmental or acquired? J Bone Joint Surg Br 1999;81(4):670–674. DOI: 10.1302/0301-620x.81b4.9682.
  18. Panjabi M, White A. Clinical biomechanics of the spine. 2nd ed., Philadelphia: J.B Lippincott Company; 1990. pp. 31–32.
  19. Xu C, Ding ZH, Xu YK. Comparison of computed tomography and magnetic resonance imaging in the evaluation of facet tropism and facet arthrosis in degenerative cervical spondylolisthesis. Genet Mol Res 2014;13(2):4102–4109. DOI: 10.4238/2014.May.30.5.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.