[annapurna]

Originally Posted by tconner94

Some background first: Facet disease is detectable by lumbar CT best, MRI next and regular back X-rays last. Further, it is seen on regular Xrays typically on "oblique" views, which are often not performed pre-op.

I'd like to make one clarification: CT are best for detecting the boney changes typified by advanced arthritic changes. That's true of any joint. MRIs are better for detecting the early stages or arthritis such as loss of cartilage, joint effusion, or inflamation. This is less true for facets because it's simply so hard to focus on the small area of the facets unless the scan is taken specifically to look at them but it is still more or less true. The delay between the cartilagenous changes, which are hard to spot, and the boney changes, which are easier, is often why someone may have substantial pain for a long time without any detectable cause. Of course, the reverse happens as well: lots of boney changes and advanced arthirits without any detectable pain.