Investigation of the Relationship Between the Frequency of Lumbar Facet Tropism and Disc Herniation and Spondylolisthesis in Patients with Low Back Pain Complaints

Objective: The relationship between facet tropism (FT) and degenerative lumbar pathologies remains controversial due to conflicting evidence.This study aimed to determine the frequency of lumbar FT in patients with low back pain and to investigate its relationship with lumbar disc herniation (LDH) and degenerative spondylolisthesis (DS) at specific spinal levels.Methods: This retrospective cross-sectional observational study included 92 patients aged 18-80 years who presented with low back pain between November 2023 and May 2025.Facet joint angles were measured on patients' lumbar magnetic resonance imaging at the L3-L4, L4-L5, and L5-S1 levels, with FT defined as a bilateral angular difference of 6 degrees or more at the same level.The relationship between the presence of FT and the presence of LDH and DS was evaluated using the chi-square test or Fisher's exact test. Results:The mean age of the 92 patients included in the study was 42.30±11.66years, and 63% were female.FT was most frequently observed at the L5-S1 level (54.3%), followed by L4-L5 (44.6%) and L3-L4 (31.5%).Statistical analyses revealed no significant association between the presence of FT and that of LDH or DS at any examined lumbar level (L3-L4, L4-L5, L5-S1) (p>0.05).Conclusion: Despite the high prevalence of FT at the lower lumbar levels, no statistically significant association was observed between the presence of FT and either LDH or DS.The findings contribute to the body of contradictory results and suggest FT may not be an independent, determining risk factor in the multifactorial etiology of lumbar degeneration.