Biomechanical and histologic studies have highlighted the close functional
relationship between lumbar discs and their associated facet joints, and it
is conceivable that their degenerative changes are interdependent. However
, separation of cause from effect remains controversial. Hitherto, no study
in humans has correlated the changes histologically. The present study ass
essed histologic changes in lower lumbar discs and their associated facet j
oints in patients under the age of 40 years using classification systems de
veloped for this investigation. A specific objective was to correlate chang
es in discs and facet joints. Data from 15 lower lumbar spine specimens wer
e obtained. Three parasagittal sections per disc and one section per facet
joint were graded histologically. The results were correlated with age, wit
hin the functional spinal unit (FSU), and with the adjacent level. Histolog
ic changes were found in discs and facet joints from all FSUs. There was no
correlation between the age of the subject and the degree of degeneration
of the disc or facet joints at either level. The extent of disc degeneratio
n at L4/5 correlated significantly with changes at L5/S1 (P < 0.01). There
was no correlation between changes in discs and the associated facet joints
at either level. The results of the study showed that microscopic changes
are seen in the disc and facet joints from an early age and can be quite ma
rked in some individuals before the age of 40 years. A correlation of degen
erative changes within the FSU could not be established.