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Vol 80, No 4 (2021)
Review article
Submitted: 2020-07-30
Accepted: 2020-10-04
Published online: 2020-10-12
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Anatomy of lumbar facet joint: a comprehensive review

S. Kapetanakis12, N. Gkantsinikoudis1
DOI: 10.5603/FM.a2020.0122
·
Pubmed: 33084010
·
Folia Morphol 2021;80(4):799-805.
Affiliations
  1. Spine Department and Deformities, Interbalkan European Medical Centre, Thessaloniki, Greece
  2. Department of Minimally Invasive and Endoscopic Spine Surgery, Athens Medical Centre, Athens, Greece

open access

Vol 80, No 4 (2021)
REVIEW ARTICLES
Submitted: 2020-07-30
Accepted: 2020-10-04
Published online: 2020-10-12

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.

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.

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Keywords

lumbar vertebrae, zygapophyseal joints, mammillo-accessory ligament, biomechanics, facet joint tropism, dorsal ramus, medial branch

About this article
Title

Anatomy of lumbar facet joint: a comprehensive review

Journal

Folia Morphologica

Issue

Vol 80, No 4 (2021)

Article type

Review article

Pages

799-805

Published online

2020-10-12

Page views

10084

Article views/downloads

5350

DOI

10.5603/FM.a2020.0122

Pubmed

33084010

Bibliographic record

Folia Morphol 2021;80(4):799-805.

Keywords

lumbar vertebrae
zygapophyseal joints
mammillo-accessory ligament
biomechanics
facet joint tropism
dorsal ramus
medial branch

Authors

S. Kapetanakis
N. Gkantsinikoudis

References (41)
  1. Adams MA, Hutton WC. The mechanical function of the lumbar apophyseal joints. Spine (Phila Pa 1976). 1983; 8(3): 327–330.
    CrossRefPubMed
  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.
    CrossRefPubMed
  3. Alonso F, Kirkpatrick CM, Jeong W, et al. Lumbar facet tropism: a comprehensive review. World Neurosurg. 2017; 102: 91–96.
    CrossRefPubMed
  4. An SJ, Seo MiS, Choi SIl, et al. Facet joint hypertrophy is a misnomer: A retrospective study. Medicine (Baltimore). 2018; 97(24): e11090.
    CrossRefPubMed
  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).
    CrossRefPubMed
  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.
    PubMed
  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.
    CrossRefPubMed
  9. Cohen SP, Raja SN. Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. Anesthesiology. 2007; 106(3): 591–614.
    CrossRefPubMed
  10. Demir-Deviren S, Singh S, Hanelin J. Superior recess access of the lumbar facet joint. Clin Spine Surg. 2017; 30(3): E169–E172.
    CrossRefPubMed
  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.
    PubMed
  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.
    CrossRefPubMed
  13. Farfan HF, Sullivan JD. The relation of facet orientation to intervertebral disc failure. Can J Surg. 1967; 10(2): 179–185.
    PubMed
  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.
    CrossRefPubMed
  15. Gellhorn AC, Katz JN, Suri P. Osteoarthritis of the spine: the facet joints. Nat Rev Rheumatol. 2013; 9(4): 216–224.
    CrossRefPubMed
  16. Inoue N, Orías AA, Segami K. Biomechanics of the lumbar facet joint. Spine Surg Relat Res. 2020; 4(1): 1–7.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  21. Louis R. Spinal stability as defined by the three-column spine concept. Anat Clin. 1985; 7(1): 33–42.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRef
  26. Perolat R, Kastler A, Nicot B, et al. Facet joint syndrome: from diagnosis to interventional management. Insights Imaging. 2018; 9(5): 773–789.
    CrossRefPubMed
  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.
    CrossRefPubMed
  28. Putz R. The functional morphology of the superior articular processes of the lumbar vertebrae. J Anat. 1985; 143: 181–187.
    PubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  38. Twomey L, Taylor J. Age changes in lumbar intervertebral discs. Acta Orthop Scand. 1985; 56(6): 496–499.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed
  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.
    CrossRefPubMed

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