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Facet syndrome is a syndrome in which the facet joints (synovial diarthroses) cause painful symptoms. [1] In conjunction with degenerative disc disease, a distinct but functionally related condition, facet arthropathy is believed to be one of the most common causes of lower back pain. [2] [3]
Facet joint arthrosis is an intervertebral disc disorder. The facet joints or zygapophyseal joints are synovial cartilage covered joints that limit the movement of the spine and preserve segmental stability. In the event of hypertrophy of the vertebrae painful arthrosis can occur. [1]
Spinal ligaments can thicken (ligamenta flava) [24] [25] Bone spurs develop on the bone and into the spinal canal or foraminal openings; Intervertebral discs may bulge or herniate into the canal or foraminal openings [26] Degenerative disc disease causes narrowing of the spaces. [27] Facet joints break down; Facet joints may hypertrophy [28]
They allow for flexion and extension and limit lateral flexion in the cervical spine. Pathological processes that can occur in these joints include degenerative changes or hypertrophic arthritis, resulting in foraminal stenosis and nerve compression. Foraminal stenosis at this joint is the most common cause of cervical nerve root pressure.
The facet joints (also zygapophysial joints, zygapophyseal, apophyseal, or Z-joints) are a set of synovial, plane joints between the articular processes of two adjacent vertebrae. There are two facet joints in each spinal motion segment and each facet joint is innervated by the recurrent meningeal nerves.
This results in spinal instability and more degenerative changes in spinal structures including facet joints, ligamentum flavum, and intervertebral discs. These pathologic changes result in narrowing of the vertebral canal and neurovascular compression at the lumbosacral nerve roots.
In the spine, there is bone formation along the anterior longitudinal ligament and sometimes the posterior longitudinal ligament, which may lead to partial or complete fusion of adjacent vertebrae. The facet and sacroiliac joints tend to be uninvolved. The thoracic spine is the most common level involved. [2]
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]