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Facet Joint Hypertrophy

Facet joint hypertrophy is a condition in which the facet joints of the spine become enlarged. The facet joints are cartilage-encased hinges that hold adjacent vertebrae together. With age, these joints can begin to degenerate and may become painfully inflamed, causing symptoms like stiffness, numbness, reduced mobility, spinal deformities, and inability to arch the spine backwards.

Enlargement of facet joints can be caused by multiple factors. Rheumatoid arthritis can cause the synovial lining of facet joints to be inflamed and swollen. Or, facet joint osteoarthritis means that cartilage on the joints has worn away. Once cartilage is gone, the body compensates by growing extra bone on the joints called bone spurs. These bone spurs can make it seem as if the joints are thicker and larger in some areas. Thus, either by inflammation or extra bone growth, facet joint “hypertrophy,” or “enlargement,” can occur.

Ultimately, the pain of facet joint hypertrophy doesn’t come from the inflammation itself, but from the effect the inflammation has on surrounding spinal nerves. The vertebrae are surrounded by openings called foramina, through which our spinal nerves pass on their way to and from the muscles and sensory organs. The swelling of facet joint hypertrophy can impinge on these neural passageways, forcing the nerves to become constricted. This is why symptoms can often be “referred,” which means they appear in places that are far from the site of damage. For instance, although you may have facet joint hypertrophy in your lower back, the numbness and pain can extend all the way through the buttocks and legs.

If you have been diagnosed with this condition, your doctor may suggest an open-spine facet joint surgery to help relieve you of your symptoms. Spinal fusion is one possible procedure. This involves bone grafts or hardware used to fasten together two or more vertebrae in an attempt to immobilize the damaged facet joints and stop the pain. You may also consider a laminectomy, which is a procedure that removes significant bone mass in an effort to widen nerve passageways, so that neural compression is lessened. Both of these traditional surgeries are invasive and can include up to a year of recovery time. You should also be prepared for inpatient hospital time and general anesthesia.

Alternatives to traditional, open-spine procedures do exist. Endoscopic technology has made it possible for people to find relief from the pain of facet joint hypertrophy without having to go through the trauma of an invasive surgery. Basically, an endoscope (a small tube with a light, microscope, and video camera) is inserted into the body through an extremely small incision. The endoscope allows the surgeon to treat the damaged area, while eliminating the large incisions of open-back surgery that can lead to muscle trauma, infection, and scarring.

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If you feel that a minimally-invasive, endoscopic procedure may be something you want to consider, contact the medical team at Laser Spine Institute (LSI). LSI is at the forefront of revolutionary, laser-assisted procedures that have helped tens of thousands of people rediscover a life without pain. Contact us today for a free review of our MRI or CT scan, and to learn more about facet joint ablation or facet joint denervation.

Please note: Laser Spine Institute currently does not perform endoscopic procedures on the thoracic spine.