Description of Facet Disease
The Facet joints are the joint structures that connect the vertebrae to one another. The facet joint is like any other joint in your body – they have cartilage that line the joint, (this allows the bone to glide smoothly over one another) and a capsule surrounding the joint. The function of the facet joint is to provide support, stability, and mobility to the vertebrae (spine). Facet Disease occurs when there is degeneration of the facet joint.
There are two facet joints between each vertebrae. They are located on each side of the vertebrae. Facet disease can occur at any level of the spine, but are most common in the lumbar region..
There are a number of terms that are used to diagnose facet problems:
- Facet Arthritis
- Facet Joint Syndrome
- Facet Disease
- Facet Hypertrophy
- Degenerative Facet Joints
In general, all of the terms mean pretty much the same thing – arthritis or degeneration of the facet joint.
Causes of Facet Disease
Facet Disease is caused by the cartilage in the joints being worn down as a result of wear and tear, 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. Another cause of Facet Disease is spondylolisthesis, which is when one vertebra slips forward in relation to an adjacent vertebra, usually in the lumbar spine.
Symptoms of Facet Disease
Symptoms related to facet joint problems are usually localized to the area of the facet joint. This can occur in the cervical (neck), thorasic (mid-back) and lumbar (lower back).
When the facets are affected in the lumbar region, a person can experience lower back pain that can go to the buttocks and upper thigh area. If the area affected is cervical, then pain can occur in the back of the neck and radiate to the top of the shoulders, and can radiate around the neck.
Treatment of Facet Disease
Since there are a lot of causes of back and neck pain, it is important that when evaluating and treating a patient that the correct diagnosis is made. Facet disease diagnosis is relatively easily to accomplish with a thorough physical exam or a diagnostic facet injection, a numbing medication injected into the facet joint. If your pain is caused from the facet joint, then the pain should resolve immediately. If you still have pain after the injection, then your pain may be caused by something else such as Spinal Stenosis or a herniated/bulging disc, which may require a different procedure to correct.
If the injection relieves the pain, then the next step would be to perform a Laser Facet Thermal Ablation. This procedure is performed through a small tube – 5mm (about the size of a straw.) The laser, fiber optics and irrigation are all placed in the tube and surgery is performed on the facet joint. The surgeon will use the laser to debride (clean the joint) and deaden the nerve that innervates the joint. This is very similar to a root canal that the dentist will perform on your tooth. This procedure takes about 40 minutes and will resolve the pain associated with the facet joint.