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Prevalence of Facet Effusion and Its Relationship with Lumbar Spondylolisthesis and Low Back Pain: The Wakayama Spine Study

Authors Shinto K, Minamide A, Hashizume H, Oka H, Matsudaira K, Iwahashi H, Ishimoto Y, Teraguchi M, Kagotani R, Asai Y, Muraki S, Akune T, Tanaka S, Kawaguchi H, Nakamura K, Yoshida M, Yoshimura N, Yamada H

Received 14 August 2019

Accepted for publication 10 December 2019

Published 31 December 2019 Volume 2019:12 Pages 3521—3528


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr E Alfonso Romero-Sandoval

Kazunori Shinto,1 Akihito Minamide,1 Hiroshi Hashizume,1 Hiroyuki Oka,2 Ko Matsudaira,2 Hiroki Iwahashi,1 Yuyu Ishimoto,1 Masatoshi Teraguchi,1 Ryohei Kagotani,1 Yoshiki Asai,1 Shigeyuki Muraki,3 Toru Akune,4 Sakae Tanaka,5 Hiroshi Kawaguchi,6 Kozo Nakamura,7 Munehito Yoshida,1,8 Noriko Yoshimura,3,* Hiroshi Yamada1,*

1Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama City, Wakayama, Japan; 2Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; 3Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; 4National Rehabilitation Center for Persons with Disabilities, Tokorozawa City, Saitama, Japan; 5Department of Orthopaedic Surgery, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; 6Tokyo Neurological Center, Minato-ku, Tokyo, Japan; 7Towa Hospital, Adachi-ku, Tokyo, Japan; 8Department of Orthopaedic Surgery, Sumiya Orthopaedic Hospital, Wakayama City, Wakayama, Japan

*These authors contributed equally to this work

Correspondence: Hiroshi Hashizume
Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama City, 811-1 Kimiidera, Wakayama City, Wakayama 641-8510, Japan
Tel +81-73-441-0645
Fax +81-73-448-3008

Introduction: Facet effusion represents a magnetic resonance imaging finding suggesting accumulation of fluid in the facet joint, potentially predictive of lumbar spondylolisthesis and low back pain. However, its prevalence and epidemiological characteristics in the general population remain unclear, because previous studies only included patients or volunteers. The aim of the present study was to investigate the prevalence of facet effusion in the general population and to describe its potential relationship with spondylolisthesis and low back pain.
Material and methods: Our study enrolled 808 participants from the Wakayama Spine Study who underwent magnetic resonance imaging investigations in supine position. Facet effusion was defined as a measurable, curvilinear, high-intensity signal within the facet joint, closely matching that of cerebrospinal fluid on the axial T2 images. We used standing lateral radiographs to diagnose L4 spondylolisthesis.
Results: We found that the prevalence of facet effusion in the lumbar spine was 34.3%, which did not differ significantly between men and women (p=0.13) and did not tend to increase with age, either in men (p=0.81) or in women (p=0.65). Additionally, we found no significant association between facet effusion and low back pain (odds ratio, 1.04–1.49; 95% confidence interval, 0.57–2.64; p=0.17–0.85), or between facet effusion and L4 spondylolisthesis (odds ratio, 1.55; 95% confidence interval, 0.80–2.86; p=0.17). In a subset of participants with L4 spondylolisthesis, we also noted that facet effusion was not significantly associated with low back pain (odds ratio, 1.26; 95% confidence interval, 0.37–4.27; p=0.70).
Discussion: This is the first study of facet effusion employing a population-based cohort, and the findings are thus expected to accurately describe the relationship between facet effusion and low back pain in the general population. We are planning a follow-up survey of the Wakayama Spine Study cohort to clarify the natural history of facet effusion and its relationship with clinical symptoms.

Keywords: lumbar spine, facet effusion, low back pain, spondylolisthesis, epidemiology

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