Relationship between disc degeneration and facet joint arthrosis-a MRI study

Introduction: Spinal degeneration includes degenerative changes occurring in the anteriorly located fibro-cartilaginous intervertebral discs and posteriorly placed synovial facet joints. The stability of each spinal motion segment is dependent on both these components. Thus an MRI based study on low back pain subjects was undertaken to assess the association between disc degeneration (DD) and facet joint arthrosis (FJA). Materials & method: The study was conducted on 50 low back patients selected on the basis of predefined questionnaire and taken up for MRI assessment for grading disc degeneration and facet joint arthrosis. The severity of DD and FJA was evaluated at each motion segment and assessed with respect to gender, spinal level and the interdependence of disc and facet joint degeneration was defined. Results: The degeneration process at the disc and facet joint was independent of gender (p > 0.05) but dependent on the spinal level (p < 0.05). Disc degenerationwas seen at the caudal most level while facet joint degeneration was seen in the L4-L5 spinal level. FJA was evident even without evidences of disc degeneration and no significant association was observed between discs and the facet joints. Discussion: The role of small facet joints should not be overlooked while defining low back pain etiology as these joints play a significant role in load transmission and rotational kinematics. This knowledge can be of help in defining appropriate treatment modality for better patient care. (C) 2017 Published by Elsevier, a division of RELX India, Pvt. Ltd on behalf of Anatomical Society of India.