Lumbar Facet Joint Morphology and Degenerative Lumbar Spondylolisthesis: A Systematic Review and Meta-Analysis.
- 1College of Medicine, Florida Atlantic University, Boca Raton, FL, USA.
- 2Department of Biomedical Engineering, Florida Atlantic University, Boca Raton, FL, USA.
- 3Department of Neurosurgery, Marcus Neuroscience Institute, Boca Raton Regional Hospital, Boca Raton, FL, USA.
Abstract
Study DesignSystematic review and meta-analysis.ObjectivesTo evaluate the associations between lumbar facet orientation, facet tropism, and degenerative lumbar spondylolisthesis (DLS), while assessing sex-specific differences in facet morphology.MethodsA PRISMA-compliant systematic review and meta-analysis was prospectively registered in PROSPERO (CRD420261417450). PubMed/MEDLINE, Embase, Scopus, Cochrane CENTRAL, and Web of Science were searched through June 2026. Studies evaluating lumbar facet morphology in adults with DLS were included. Random-effects meta-analyses using restricted maximum likelihood estimation and Hartung-Knapp adjustment were performed. Risk of bias and evidence certainty were assessed.ResultsThirty-nine studies met the inclusion criteria. Sixteen studies (3,321 participants) were included in the facet orientation meta-analysis. Patients with DLS demonstrated more sagittally oriented facet joints than controls (SMD 1.30, 95% CI 0.78-1.82; p < 0.0001; I² = 97.2%). Nine studies (1,913 participants) showed greater continuous facet tropism in DLS patients (MD 2.72°, 95% CI 2.07°-3.38°; p < 0.0001; I² = 47.2%). Binary facet tropism was not statistically significant (OR 2.20, 95% CI 0.85-5.66; p = 0.0817). Sex-specific, severity, and instability data were insufficient for quantitative synthesis.ConclusionDLS is associated with more sagittally oriented facet joints and greater continuous facet tropism than controls. Limited sex-specific data and heterogeneity highlight the need for standardized measurement techniques and prospective longitudinal studies to clarify causality and sex-related effects.
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BibTeX
@article{suarez2026lumbar,
title = {{Lumbar Facet Joint Morphology and Degenerative Lumbar Spondylolisthesis: A Systematic Review and Meta-Analysis.}},
author = {Alberto Suarez and Justin Gumbs and Michelle Schmidt and Zeena Shather and Hanna Neustadter and Dominic Lafalce and Marissa Middleton and Jaden Wise and Isabella Merem and Maohua Lin and Frank D Vrionis},
journal = {Global spine journal},
year = {2026},
month = oct,
doi = {10.1177/21925682261499356},
url = {https://europepmc.org/article/MED/42893425},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Lumbar Facet Joint Morphology and Degenerative Lumbar Spondylolisthesis: A Systematic Review and Meta-Analysis.
AU - Alberto Suarez
AU - Justin Gumbs
AU - Michelle Schmidt
AU - Zeena Shather
AU - Hanna Neustadter
AU - Dominic Lafalce
AU - Marissa Middleton
AU - Jaden Wise
AU - Isabella Merem
AU - Maohua Lin
AU - Frank D Vrionis
PY - 2026
DA - 2026/10/18
JO - Global spine journal
DO - 10.1177/21925682261499356
UR - https://europepmc.org/article/MED/42893425
AB - Study DesignSystematic review and meta-analysis.ObjectivesTo evaluate the associations between lumbar facet orientation, facet tropism, and degenerative lumbar spondylolisthesis (DLS), while assessing sex-specific differences in facet morphology.MethodsA PRISMA-compliant systematic review and meta-analysis was prospectively registered in PROSPERO (CRD420261417450). PubMed/MEDLINE, Embase, Scopus, Cochrane CENTRAL, and Web of Science were searched through June 2026. Studies evaluating lumbar facet morphology in adults with DLS were included. Random-effects meta-analyses using restricted maximum likelihood estimation and Hartung-Knapp adjustment were performed. Risk of bias and evidence certainty were assessed.ResultsThirty-nine studies met the inclusion criteria. Sixteen studies (3,321 participants) were included in the facet orientation meta-analysis. Patients with DLS demonstrated more sagittally oriented facet joints than controls (SMD 1.30, 95% CI 0.78-1.82; p < 0.0001; I² = 97.2%). Nine studies (1,913 participants) showed greater continuous facet tropism in DLS patients (MD 2.72°, 95% CI 2.07°-3.38°; p < 0.0001; I² = 47.2%). Binary facet tropism was not statistically significant (OR 2.20, 95% CI 0.85-5.66; p = 0.0817). Sex-specific, severity, and instability data were insufficient for quantitative synthesis.ConclusionDLS is associated with more sagittally oriented facet joints and greater continuous facet tropism than controls. Limited sex-specific data and heterogeneity highlight the need for standardized measurement techniques and prospective longitudinal studies to clarify causality and sex-related effects.
SN - 2192-5682
SN - 2192-5690
ER -