Facet Disease

Facet joints are the structures that connect the spinal vertebrae to each other. The facet joint is like many other joints in the body – it has a cartilage lining that allows the bones to glide smoothly over each other and is surrounded by a protective capsule. The function of a facet joint is to provide stability, mobility, and support to the spine. Each vertebra has two facet joints, one on each side.

Causes

Facet disease is caused by the cartilage in the joints being worn down as a result of wear, aging, injury, or misuse. This type of injury to the spine can be attributed to arthritis of the spine, work, over-use, or an accident. Facet disease occurs when a facet joint degenerates. While this can take place at any level of the spine, it most commonly affects the lumbar (lower spine) region. Another possible result of facet disease is spondylolisthesis, which occurs when a vertebra slips forward in relation to an adjacent vertebra, usually in the lumbar spine.

Conservative Treatment

Since there are many causes of neck and back pain, it is important to obtain the proper diagnosis. Facet disease diagnosis is relatively easy to accomplish without a thorough physical exam or a diagnostic facet injection (a numbing medication injected into the facet joint). If the source of the pain is the facet joint then the pain should resolve immediately after the injection, if the pain persists after the facet injection then it may be caused by spinal stenosis or a herniated disc/bulging disc, which may require different treatments.

Symptoms

Symptoms related to facet joint problems are usually localized to the area of the affected joint and are often experienced in the cervical (neck), thoracic (mid-back), and lumbar (lower back) regions. When facts in the lumbar region are affected, a patient may experience lower back pain that radiates to the buttocks and upper thigh area. If facets in the cervical area are affected, pain may occur in the back of the neck and radiate to the top of the shoulders or around the neck

Diagnosis

Some of the terms commonly used in the diagnosis of facet problems include:

Facet arthritis
Facet joint syndrome
Facet disease
Facet hypertrophy
Degenerative facet joints

These terms all refer to essentially the same thing – osteoarthritis or degeneration of a facet joint.

Minimally Invasive Surgery

If an infection doesn’t effectively relieve the pain the next step could be laser facet thermal ablation, which is performed through a small tube (approximately the size of a quarter) and is a safer and more effective alternative to traditional open back surgery. The laser, fiber optics, and irrigation apparatus are placed in the tube to facilitate surgery on the facet joint. Facet thermal ablation is normally performed in combination with a decompression procedure.

The board-certified surgeons at BEST Health System will use a small incision to debride (clean) the joint and deaden the local joint nerve, similar to a root canal procedure performed by an endodontist on a tooth. Laser facet thermal ablation takes a short period of time to complete and can help resolve the pain associated with the facet joint. Contact us with any questions or concerns you may have about our outpatient procedures.