Bone and soft tissue injuries in post-mortem lumbar spines

A histological study of transverse sections of lumbar facet joints from 36 lumbar spines of subjects dying from serious trauma revealed injuries not visible on standard radiography, and in a high percentage of joints. They include fractures of the superior articular process, central infractions of the subchondral bone plate, and tears of the articular capsule, including the ligamentum flavum. The facet joint injuries in young subjects were almost entirely absent from the facet joints of a comparable group of young subjects with no recent history of major trauma. The injuries resemble some of the 'age changes' seen in older subjects dying non-violent deaths. It is suggested that such injuries may lead to early onset facetal arthritis in survivors of major trauma.