Vol 80, No 4 (2021)
Review article
Published online: 2020-10-12

open access

Page views 10937
Article views/downloads 6441
Get Citation

Connect on Social Media

Connect on Social Media

Anatomy of lumbar facet joint: a comprehensive review

S. Kapetanakis12, N. Gkantsinikoudis1
Pubmed: 33084010
Folia Morphol 2021;80(4):799-805.

Abstract

Lumbar facet joints (LFJs) are diarthrodial joints which provide articulation between two adjacent lumbar vertebrae. LFJs represent complex anatomic structures with multifaceted biomechanical and functional characteristics. They are theorized as structures of crucial clinical significance since their degenerative morphologic alterations are frequently related to emergence of low back pain. Despite the emerging interest in describing LFJs anatomy in recent years, precise description of LFJs innervation remains controversial. In this comprehensive review, anatomy and biomechanical importance of LFJs and associated adjacent extra-articular structures are thoroughly presented. Furthermore, LFJs innervation in respect to current literature data is punctually analysed. Knowledge of anatomy and innervation LFJs of critical importance for clinicians and spine surgeons, so that patients are properly evaluated and related therapeutic procedures are rationally performed.

Article available in PDF format

View PDF Download PDF file

References

  1. Adams MA, Hutton WC. The mechanical function of the lumbar apophyseal joints. Spine (Phila Pa 1976). 1983; 8(3): 327–330.
  2. Ahmed AM, Duncan NA, Burke DL. The effect of facet geometry on the axial torque-rotation response of lumbar motion segments. Spine (Phila Pa 1976). 1990; 15(5): 391–401.
  3. Alonso F, Kirkpatrick CM, Jeong W, et al. Lumbar facet tropism: a comprehensive review. World Neurosurg. 2017; 102: 91–96.
  4. An SJ, Seo MiS, Choi SIl, et al. Facet joint hypertrophy is a misnomer: A retrospective study. Medicine (Baltimore). 2018; 97(24): e11090.
  5. Ban E, Zhang S, Zarei V, et al. Collagen organization in facet capsular ligaments varies with spinal region and with ligament deformation. J Biomech Eng. 2017; 139(7).
  6. Bogduk N. Clinical anatomy of the lumbar spine and sacrum. 3rd ed. Churchill Livingstone, Edinburgh 1997.
  7. Bogduk N, Wilson AS, Tynan W. The human lumbar dorsal rami. J Anat. 1982; 134(Pt 2): 383–397.
  8. Chadha M, Sharma G, Arora SS, et al. Association of facet tropism with lumbar disc herniation. Eur Spine J. 2013; 22(5): 1045–1052.
  9. Cohen SP, Raja SN. Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. Anesthesiology. 2007; 106(3): 591–614.
  10. Demir-Deviren S, Singh S, Hanelin J. Superior recess access of the lumbar facet joint. Clin Spine Surg. 2017; 30(3): E169–E172.
  11. Demondion X, Vidal C, Glaude E, et al. The posterior lumbar ramus: CT-anatomic correlation and propositions of new sites of infiltration. AJNR Am J Neuroradiol. 2005; 26(4): 706–710.
  12. Dupont G, Yilmaz E, Iwanaga J, et al. Ossification of the mamillo-accessory ligament: a review of the literature and clinical considerations. Anat Cell Biol. 2019; 52(2): 115–119.
  13. Farfan HF, Sullivan JD. The relation of facet orientation to intervertebral disc failure. Can J Surg. 1967; 10(2): 179–185.
  14. Gao T, Lai Qi, Zhou S, et al. Correlation between facet tropism and lumbar degenerative disease: a retrospective analysis. BMC Musculoskelet Disord. 2017; 18(1): 483.
  15. Gellhorn AC, Katz JN, Suri P. Osteoarthritis of the spine: the facet joints. Nat Rev Rheumatol. 2013; 9(4): 216–224.
  16. Inoue N, Orías AA, Segami K. Biomechanics of the lumbar facet joint. Spine Surg Relat Res. 2020; 4(1): 1–7.
  17. Ishihara H, Matsui H, Osada R, et al. Facet joint asymmetry as a radiologic feature of lumbar intervertebral disc herniation in children and adolescents. Spine (Phila Pa 1976). 1997; 22(17): 2001–2004.
  18. Jiang X, Chen D, Li Z, et al. Correlation between lumbar spine facet joint orientation and intervertebral disk degeneration: a positional MRI analysis. J Neurol Surg A Cent Eur Neurosurg. 2019; 80(4): 255–261.
  19. Kozera K, Ciszek B. Posterior branches of lumbar spinal nerves - part I: anatomy and functional importance. Ortop Traumatol Rehabil. 2016; 18(1): 1–10.
  20. Kozera K, Ciszek B, Szaro P. Posterior branches of lumbar spinal nerves. Part II: lumbar facet syndrome - pathomechanism, symptomatology and diagnostic work-up. Ortop Traumatol Rehabil. 2017; 19(2): 101–109.
  21. Louis R. Spinal stability as defined by the three-column spine concept. Anat Clin. 1985; 7(1): 33–42.
  22. Mahato NK. Facet dimensions, orientation, and symmetry at L5-S1 junction in lumbosacral transitional States. Spine (Phila Pa 1976). 2011; 36(9): E569–E573.
  23. 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.
  24. O'Leary SA, Link JM, Klineberg EO, et al. Characterization of facet joint cartilage properties in the human and interspecies comparisons. Acta Biomater. 2017; 54: 367–376.
  25. Pedersen H, Blunck C, Gardner E. The anatomy of lumbosacral posterior rami and meningeal branches of spinal nerves (sinu-vertebral nerves). J Bone Joint Surg. 1956; 38(2): 377–391.
  26. Perolat R, Kastler A, Nicot B, et al. Facet joint syndrome: from diagnosis to interventional management. Insights Imaging. 2018; 9(5): 773–789.
  27. Proietti L, Schirò GR, Sessa S, et al. The impact of sagittal balance on low back pain in patients treated with zygoapophysial facet joint injection. Eur Spine J. 2014; 23 Suppl 6: 628–633.
  28. Putz R. The functional morphology of the superior articular processes of the lumbar vertebrae. J Anat. 1985; 143: 181–187.
  29. Saito T, Steinke H, Miyaki T, et al. The medial branch of the lateral branch of the posterior ramus of the spinal nerve. Surg Radiol Anat. 2006; 28(3): 228–234.
  30. Saito T, Yoshimoto M, Yamamoto Y, et al. The medial branch of the lateral branch of the posterior ramus of the spinal nerve. Surg Radiol Anat. 2006; 28(3): 228–234.
  31. Shuang F, Hou SX, Zhu JL, et al. Clinical anatomy and measurement of the medial branch of the spinal dorsal ramus. Medicine (Baltimore). 2015; 94(52): e2367.
  32. Song Q, Liu X, Chen DJ, et al. Evaluation of MRI and CT parameters to analyze the correlation between disc and facet joint degeneration in the lumbar three-joint complex. Medicine (Baltimore). 2019; 98(40): e17336.
  33. Steinke H, Saito T, Miyaki T, et al. Anatomy of the human thoracolumbar Rami dorsales nervi spinalis. Ann Anat. 2009; 191(4): 408–416.
  34. Suseki K, Takahashi Y, Takahashi K, et al. Innervation of the lumbar facet joints. Origins and functions. Spine (Phila Pa 1976). 1997; 22(5): 477–485.
  35. Tessitore E, Molliqaj G, Schatlo B, et al. Clinical evaluation and surgical decision making for patients with lumbar discogenic pain and facet syndrome. Eur J Radiol. 2015; 84(5): 765–770.
  36. Thorpe Lowis CG, Xu Z, Zhang M. Visualisation of facet joint recesses of the cadaveric spine: a micro-CT and sheet plastination study. BMJ Open Sport Exerc Med. 2018; 4(1): e000338.
  37. Tulsi RS, Hermanis GM. A study of the angle of inclination and facet curvature of superior lumbar zygapophyseal facets. Spine (Phila Pa 1976). 1993; 18(10): 1311–1317.
  38. Twomey L, Taylor J. Age changes in lumbar intervertebral discs. Acta Orthop Scand. 1985; 56(6): 496–499.
  39. Varlotta GP, Lefkowitz TR, Schweitzer M, et al. The lumbar facet joint: a review of current knowledge: part 1: anatomy, biomechanics, and grading. Skeletal Radiol. 2011; 40(1): 13–23.
  40. Wang H, Zhang Z, Zhou Y. Irregular alteration of facet orientation in lumbar segments: possible role in pathology of lumbar disc herniation in adolescents. World Neurosurg. 2016; 86: 321–327.
  41. 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.