Facet tropism - A comparison between far lateral and posterolateral lumbar disc herniations

Study Design. An assessment of the difference in the degree of facet tropism and disc degeneration between far lateral and posterolateral lumbar disc herniations. Objective. To investigate the effect of the difference in the degree of the facet tropism and disc degeneration with respect to the development of far lateral lumbar disc herniation and posterolateral lumbar disc herniation, and to compare the effect between the two types of herniations. Summary of Background Data. The effect of facet tropism on the development of posterolateral lumbar disc herniation has been investigated previously, but there has been no study on far lateral lumbar disc herniation. Methods. Thirty-eight lumbar disc herniations (far lateral, n = 19; posterolateral, n = 19) were included this study. The degree of facet tropism and disc degeneration was measured at the herniated disc level by using magnetic resonance imaging. The results were compared to show any differences between the two types of lumbar disc herniations. Results. There were significant differences in the degree of facet tropism (24.74 vs. 14.26, P = 0.004) and disc degeneration (23.92 vs. 15.08, P = 0.005) between the far lateral and posterolateral lumbar disc herniations. There was no significant correlation between the degree of facet tropism and the degree of disc degeneration in far lateral lumbar disc herniation (r = -0.369, P = 0.120). Conclusion. This results suggest that the differences in the degree of facet tropism and disc degeneration might be considered a key factor in distinguishing the development of far lateral lumbar disc herniation from that of posterolateral lumbar disc herniation.