Correlation between lumbar disc herniation and facet joint inflammation: a comprehensive MRI-based cohort study of 303 patients
Global Spine Congress 2026, İstanbul, Türkiye, 27 - 30 Mayıs 2026, ss.677, (Özet Bildiri)
- Yayın Türü: Bildiri / Özet Bildiri
- Basıldığı Şehir: İstanbul
- Basıldığı Ülke: Türkiye
- Sayfa Sayıları: ss.677
- Gazi Üniversitesi Adresli: Evet
Özet
Introduction: Low back pain (LBP) is a leading cause of disability worldwide, often arising from complex interactions within the spinal three-joint complex. Lumbar disc herniation (LDH) and facet joint (FJ) inflammation are common pain generators that frequently present with overlapping symptoms, complicating diagnosis and management. Although both entities have been extensively studied, the correlation between LDH severity and FJ inflammation remains poorly defined. This study aimed to investigate the relationship between LDH severity and FJ inflammatory changes using a large MRI based cohort. Material and Methods: A retrospective cohort of 303 patients (161 females, 142 males; mean age 45.5 ± 12.3 years) who underwent lumbar MRI for LBP between 2023 and 2024 was analyzed. LDH severity was graded using the Michigan State University (MSU) classification, which stratifies herniations by size and location. FJ inflammation was scored on a 0-3 scale incorporating joint effusion, bone marrow edema, and soft tissue edema. Two blinded radiolo gists independently evaluated all images. Level and side of LDH and FJ inflammation were recorded. Patients were stratified into two age groups: < 40 years (n = 140; age range 20-39) and ≥ 40 years (n =163; age range 40-79) for subgroup analyses. Correlation analyses were performed using Spear man’s rho. Results: The most frequently affected levels were L4-L5 (44.6%) and L5-S1 (41.2%). LDH severity demon strated a significant positive correlation with FJ inflammation score (ρ = 0.314, p < 0.001) and with the side of FJ in flammation (ρ = 0.276, p < 0.001). FJ inflammation score was strongly correlated with the side of inflammation (ρ = 0.945, p < 0.001). Edema was most frequently ipsilateral to the herniated disc, consistent with the observed correlation be tween mechanical compression and local inflammatory re sponse. Age group analysis revealed no significant differences in LDH or FJ scores; however, weak negative correlations were observed between age and herniation level (ρ =-0.180, p=0.002) aswell asage andside ofherniation (ρ =-0.120, p = 0.036). Conclusion: This study demonstrates that higher LDH severity is associated with greater ipsilateral FJ inflammation, supporting the hypothesis of biomechanical and inflammatory interaction between these structures. The findings highlight the importance of considering concomitant FJ pathology in patients with LDH to improve diagnostic accuracy and guide individualized management strategies for LBP.