ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Is facet joint tropism associated with spondylolysis and isthmic spondylolisthesis?
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the association between facet joint tropism (FJT) and spondylolysis, with or without isthmic spondylolisthesis (IS), in a large cohort of patients across a wide age range.
methodsWe retrospectively analyzed lumbar computed tomography scans from 358 patients (mean age 48.2 ± 20 years), including 191 patients with spondylolysis (137 with IS) and 167 age- and sex-matched controls without spondylolysis. Bilateral facet joint angles (FJA) were measured at L3-L4, L4-L5, and L5-S1. FJT was defined as a right-to-left FJA difference >6°. Absolute FJA differences and the prevalence of dichotomous FJT were compared between groups. Inter- and intra-observer agreement were assessed using intraclass correlation coefficients (ICC).
resultsInter- and intra-observer agreement for FJA measurements were excellent (ICC = 0.88 for both). Patients with spondylolysis demonstrated more FJA asymmetry than controls at L3-L4 (5.8° versus 3.7%; p = 0.02), L4-L5 (6.6° versus 3.9°; p < 0.01), and L5-S1 (6.7° versus 4.5°; p < 0.01), with a higher prevalence of FJT at all levels (56% versus 38%, 66% versus 36%, and 68% versus 47%, respectively; all p < 0.01). Patients with IS also showed greater FJA asymmetry and more frequent FJT at L3-L4 and L4-L5, but not at L5-S1.
conclusionPatients with spondylolysis, with or without IS, demonstrated significantly greater facet joint asymmetry and a higher prevalence of FJT than controls. The presence of FJT at adjacent levels suggests that it may represent a generalized anatomical characteristic rather than a purely local phenomenon.
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