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ORIGINAL RESEARCH article
Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 13 - 2025 | doi: 10.3389/fbioe.2025.1502082
Degenerative Relationships in Lumbar Intervertebral Discs and Facet Joints: An MRI-Based Comparative Study of Asymptomatic Individuals and Patients with Chronic and Intermittent Low Back Pain
Provisionally accepted- 1 Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité Medical University of Berlin, Berlin, Germany
- 2 Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
Degeneration of intervertebral discs and facet joints are common conditions that are thought to be interrelated. This study aimed to investigate the morphological interplay between disc and facet degeneration, as well as relationships between adjacent discs and facets. This prospective study involved 712 participants (307 males, 405 females) categorized into three groups: no back pain (no-BP), intermittent (iLBP), and chronic low back pain (cLBP). The Pfirrmann classification was used to assess intervertebral disc degeneration of index and adjacent segments, while the Fujiwara classification evaluated facet joint degeneration.Spearman's correlation coefficient analyzed relationships between degenerative changes in discs and facets.Overall, from the 712 participants 254 were with no-BP, 159 with intermittent LBP, and 299 with chronic LBP. The severity of both intervertebral disc and facet joint degeneration in the MRI sequences increased from upper to lower segments, with a significant clear directionality in differences between the uppermost and lowermost levels (p<0.01). A strong positive correlation was observed between degenerative changes of adjacent intervertebral discs, especially in the upper and middle lumbar spine (ρ>0.69). However, correlations between intervertebral disc and facet joint degeneration were weak in all populations studied (ρ<0.31).The data indicate a directionality in the disease progression, with a strong correlation observed between adjacent intervertebral discs, suggesting a concurrent degenerative process. In contrast, the weak correlations between disc and facet joint degeneration imply that these structures undergo independent degenerative processes, particularly in the early stages of degeneration. Further research is essential to elucidate the underlying mechanisms and to develop precise therapeutic interventions for lumbar spine degeneration.
Keywords: degeneration, Facet joints, Intervertebral Disc, lumbar spine, morphology, MRI
Received: 26 Sep 2024; Accepted: 27 Mar 2025.
Copyright: © 2025 Schmidt, Reitmaier, Yang, Duda and Pumberger. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hendrik Schmidt, Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité Medical University of Berlin, Berlin, Germany
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