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Facet joint injections came into use from 1963, when Hirsch injected a hypertonic solution of saline into facet joints. [3] He found that this solution relieved lower back pain in the sacroiliac and gluteal regions of the spine. In 1979 fluoroscopy was used for guidance of the needle into the facet joints with steroids and local anesthetics. [3]
Bertolotti's syndrome is characterized by sacralization of the lowest lumbar vertebral body and lumbarization of the uppermost sacral segment. It involves a total or partial unilateral or bilateral fusion of the transverse process of the lowest lumbar vertebra to the sacrum, leading to the formation of a transitional 5th lumbar vertebra.
Facet joints also prevent each vertebra from slipping over the one below. A small capsule surrounds each facet joint providing a nourishing lubricant for the joint. Also, each joint has a rich supply of tiny nerve fibers that provide a painful stimulus when the joint is injured or irritated. Inflamed facets can cause a powerful muscle spasm.
For example, the facet joint between T1 and T2 is innervated by C8 and T1 medial branch nerves. Facet joint between L1 and L2; the T12 and L1 medial branch nerves. However, the L5 and S1 facet joint is innervated by the L4 medial branch nerve and the L5 dorsal ramus. In this case, there is no L5 medial branch to innervate the facet joint.
The symptoms of low back pain usually improve within a few weeks from the time they start, with 40–90% of people recovered by six weeks. [2] In most episodes of low back pain a specific underlying cause is not identified or even looked for, with the pain believed to be due to mechanical problems such as muscle or joint strain.
Imaging, such as magnetic resonance imaging, can be used to rule out other pathologies. In many cases, this diagnosis is made after treatment of more common pathologies with similar symptoms. The most common overlapping pathologies include facet joint pain, sacroiliac joint dysfunction, and lumbosacral radiculopathy.
Research is ongoing in the efficacy determination of artificial replacements for the facet joints of the human spine. An artificial facet replacement is a joint prosthesis intended to replace the natural facets and other posterior elements of the spine, restoring normal (or near-normal) motion while providing stabilization of spinal segments.
The sacroiliac joint is essentially halfway between the ventral and dorsal sides of the body deep within the pelvis, a location in close proximity to several vital structures. Those structures within a few centimeters of the sacroiliac joint include the sacrum, ilium, sciatic nerve, dorsal and ventral sacral nerves, lumbar plexus, superior ...