{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:40:32Z","timestamp":1792482032468,"version":"4.5.0"},"reference-count":53,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Marcus Neuroscience Institution","award":["C-24-335"],"award-info":[{"award-number":["C-24-335"]}]},{"name":"Helene and Stephen Weicholz Foundation"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the associations between lumbar facet orientation, facet tropism, and degenerative lumbar spondylolisthesis (DLS), while assessing sex-specific differences in facet morphology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A PRISMA-compliant systematic review and meta-analysis was prospectively registered in PROSPERO (CRD420261417450). PubMed\/MEDLINE, Embase, Scopus, Cochrane CENTRAL, and Web of Science were searched through June 2026. Studies evaluating lumbar facet morphology in adults with DLS were included. Random-effects meta-analyses using restricted maximum likelihood estimation and Hartung\u2013Knapp adjustment were performed. Risk of bias and evidence certainty were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-nine studies met the inclusion criteria. Sixteen studies (3,321 participants) were included in the facet orientation meta-analysis. Patients with DLS demonstrated more sagittally oriented facet joints than controls (SMD 1.30, 95% CI 0.78\u20131.82; p &lt; 0.0001; I\n                      <jats:sup>2<\/jats:sup>\n                      = 97.2%). Nine studies (1,913 participants) showed greater continuous facet tropism in DLS patients (MD 2.72\u00b0, 95% CI 2.07\u00b0\u20133.38\u00b0; p &lt; 0.0001; I\n                      <jats:sup>2<\/jats:sup>\n                      = 47.2%). Binary facet tropism was not statistically significant (OR 2.20, 95% CI 0.85\u20135.66; p = 0.0817). Sex-specific, severity, and instability data were insufficient for quantitative synthesis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DLS is associated with more sagittally oriented facet joints and greater continuous facet tropism than controls. Limited sex-specific data and heterogeneity highlight the need for standardized measurement techniques and prospective longitudinal studies to clarify causality and sex-related effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261499356","type":"journal-article","created":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T13:51:43Z","timestamp":1792331503000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lumbar Facet Joint Morphology and Degenerative Lumbar Spondylolisthesis: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","author":[{"given":"Alberto","family":"Suarez","sequence":"first","affiliation":[{"name":"Florida Atlantic University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Gumbs","sequence":"additional","affiliation":[{"name":"Florida Atlantic University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Florida Atlantic University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeena","family":"Shather","sequence":"additional","affiliation":[{"name":"Florida Atlantic University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Neustadter","sequence":"additional","affiliation":[{"name":"Florida Atlantic University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Lafalce","sequence":"additional","affiliation":[{"name":"Florida Atlantic University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1253-7582","authenticated-orcid":false,"given":"Marissa","family":"Middleton","sequence":"additional","affiliation":[{"name":"Florida Atlantic University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1479-4599","authenticated-orcid":false,"given":"Jaden","family":"Wise","sequence":"additional","affiliation":[{"name":"Florida Atlantic University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Merem","sequence":"additional","affiliation":[{"name":"Florida Atlantic University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maohua","family":"Lin","sequence":"additional","affiliation":[{"name":"Florida Atlantic University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank D.","family":"Vrionis","sequence":"additional","affiliation":[{"name":"Marcus Neuroscience Institute"},{"name":"Boca Raton Regional Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,18]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2100990"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2024.01.001"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa070302"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2020.05.541"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199318110-00012"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181aa2acb"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/2453503"},{"key":"e_1_3_7_9_2","volume-title":"JBJS Reviews","author":"Yoshihara H","unstructured":"Yoshihara H. 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