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Facet tropism: possible role in the pathology of lumbar disc herniation in adolescents. OBJECTIVE The role of facet tropism (FT) in lumbar disc herniation (LDH) is ambiguous. The present study aimed to investigate the association between FT and LDH in adolescents. METHODS This study included 65 adolescents with LDH with 1- or 2-level LDH, or both. Facet angles were measured with MRI. FT was defined as asymmetry of 10° between the left and right side. The same levels of 30 healthy persons who had no lumbar lesions were used as controls. Statistical analysis was performed using the chi-square test. RESULTS FT was identified in 16 of 39 patients with LDH in L4-5 and in 3 of 30 controls (p = 0.006, OR 6.261, 95% CI 1.619-24.217). It was also identified in 12 of 27 patients with LDH in L5-S1 and in 4 of 30 controls (p = 0.017, OR 5.200, 95% CI 1.420-19.039). One patient had LDH in both L4-5 and L5-S1. CONCLUSIONS FT is associated with LDH in both L4-5 and L5-S1 levels in adolescents.