The Prevalence of Lumbar Spine Facet Joint Osteoarthritis and Its Association with Low Back Pain in Selected Korean Populations

Abstract

BackgroundThis study was to evaluate the association of lumbar spine facet joint osteoarthritis (LSFJOA) identified by multi-detector computed tomography (MDCT) with age and low back pain (LBP) in an adult community-based population in Korea.MethodsA sample of 472 participants (age range, 20 to 84 years) who underwent MDCT imaging for abdominal or urological lesions, not for chief complaints of LBP, were included in this study. LSFJOA based on MDCT findings was characterized using four grades of osteoarthritis of the facet joints. The prevalence of LSFJOA according to age group (below 40 years, 40-49 years, 50-59 years, 60-69 years, and above 70 years), gender, and spinal level was analyzed using chi-square tests and the association between LBP and LSFJOA adjusting for age, gender, and spine level was analyzed using multiple binary logistic regression test.ResultsEighty-three study subjects (17.58%) had LSFJOA (grade ≥ 2). The prevalence of LSFJOA was not associated with gender (p = 0.092). The prevalence of LSFJOA increased with age (p = 0.015). The highest prevalence of LSFJOA was observed at L4-5 in men (p = 0.001) and at L5-S1 in women (p = 0.003), and at L5-S1 in the overall population (p = 0.000). LSFJOA was not associated with LBP in men (p = 0.093) but was associated with LBP in women (p = 0.003), especially at L3-4 (p = 0.018) and L5-S1 (p = 0.026).ConclusionsThe prevalence of LSFJOA based on the computed tomography imaging was 17.58% in the adult community Korean population. The prevalence of LSFJOA increased with age, and the highest prevalence was noted at L5-S1. LSFJOA was not associated with LBP at any spinal level and age except at L3-4 and L5-S1 in women.

Optimal Cut-Off Value of the Superior Articular Process Area as a Morphological Parameter to Predict Lumbar Foraminal Stenosis

“…The LFS patients had significantly higher SAPA values than did control subjects. This study only included individuals >60 years of age because previous studies found that facet joints had only minimal cartilage changes before the age of 45 years and that osteoarthritic changes advance with age [8]. Our interpretation of these associations is that hypertrophy may be related to continuous stress, which might increase the SAPA.…”

“…Lumbar foraminal stenosis (LFS) is defined as when the spinal nerve roots are compressed on the side due to narrowing of the foramen that may be caused by a foraminal herniated disc, a collapsed disc space, or an enlarged joint [6]. The foramen can be narrowed further by characteristic changes in the facet joints such as synovial cysts, osteoarthritis, or hypertrophy of articular processes [8, 9]. All of the changes contribute to LFS symptoms [4, 5].…”

Facet Joints of the Spine: Structure–Function Relationships, Problems and Treatments, and the Potential for Regeneration

“…A computed tomography (CT)-based study of people with a mean age of 67 years found severe lumbar facet OA in 54% of patients (7). Prevalence may vary by ethnicity; a recent CT-based study of the lumbar spine of Korean patients reported a prevalence as low as ∼18% (66). Lumbar facet degeneration is most commonly found at L4-L5 and L5-S1; however, all lumbar levels are considered susceptible (6,(66)(67)(68)(69).…”

Comparison of facet joint degeneration in firefighters and hospital office workers

“…FJD differences between the two groups were clearly observed by MRI. This is in contrast to previous studies that explained differences in occupational burden based on LBP alone [37–42], and to a study that used MRI and compared nurses according to each duty to determine the presence or absence of LBP or severe disk degeneration [43]. This study selected FFs with a high lumbar load and HOWs, who were believed to have relatively lower lumbar loads, and demonstrated that occupational lumbar load could lead to FJD.…”