Oral Presentation Sydney Spinal Symposium 2019

A dissection investigation of human lumbar spine zygapophyseal (facet) joint meniscoids (#13)

Ross Partington 1
  1. Paddington Osteopathic and Dance Injury Centre, Paddington, NSW, Australia

Introduction: The existence of human lumbar synovial zygapophyseal joint meniscoids has been established for some time. Adipose and fibroadipose inclusion types and connective tissue rim types have been described. There have been various hypotheses regarding the contribution these structures may have to the function of the joint, and regarding their potential role as a cause of low back pain and intersegmental hypomobility. The purpose of this study was to carry out a dissection investigation and photographic essay of these meniscoids and consider our findings in relation to prevailing hypotheses. Methods: Lumbar zygapophyseal joints were harvested intact from four cadavers and one prosected spine. Joint capsules were sliced along caudocephalic margins and partially opened, great care taken not to disrupt any capsular or rim structures. Macroscopic and microscopic photographs were taken from various angles and at incrementally increasing degrees of joint opening. Results: The meniscoids were compared at bilateral same-segment levels in each spine, unilateral same-segment levels in all spines, and all-segment levels in all spines, and we found no concordance in the presence, type, shape, size, number, or location of meniscoids. We identified several shapes not previously described. Conclusions: We did not find evidence to support previous hypotheses that human lumbar zygapophyseal joint meniscoids are strategically typed, shaped or positioned to provide organised functional roles within the joint. We did identify new and novel mechanisms that could potentially cause joint pain.