• Weijie Yu, Xinyu Wan, Yihan Zhang, Xianlong Yue, Mengxian Jia, Minghang Chen, Jiaxin Lai, Guoting Xu, and Honglin Teng.
• Department of Orthopedics (Spine Surgery), The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China.
• Eur Spine J. 2024 Aug 1; 33 (8): 300830163008-3016.

PurposeTo evaluate the association between facet joints cross-sectional area asymmetry (FCAA) and cervical intervertebral disc herniation (CDH).MethodsOverall, we retrospectively recruited 390 consecutive patients with CDH who underwent surgical treatment at our institution and 50 normal participants. Clinical variables and radiological findings related to CDH were collected.ResultsPatients with CDH were more likely to have a higher absolute value of the facet asymmetry factor (FAF) (p  < .001), in which the FAF value of the left group was significantly higher than the other groups (p  < .001) and the right group was lower than the central group (p  < .001). 9.62% (C3/4), 12.19% (C4/5), 8.70% (C5/6), and 8.14% (C6/7) were determined as cutoff values for each variable that maximized sensitivity and specificity. Furthermore, multivariate analysis showed that cross-sectional area asymmetry of the facet joint (FCAA) was an independent risk factor for the occurrence of CDH. Also, the Chi-square test showed a significant difference in the distribution of the degeneration classification of the disc between the facet-degenerated group and the nondegenerated group at C5/6 (p = 0.026) and C6/7 (p = 0.005) in the facet asymmetry (FA) group.ConclusionsFCAA is evaluated as an independent risk factor for CDH and associated with the orientation of disc herniation. And facet joint orientation may also play a role in cervical spine degeneration rather than facet joint tropism.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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