Causes of facet disease
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.
Symptoms of facet disease
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 facets 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.
Facet disease Treatment
Since there are many causes of neck and back pain, it is important to obtain a proper diagnosis. Facet disease diagnosis is relatively easy to accomplish with 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 an injection, it may be caused by spinal stenosis or a herniated/bulging disc, which require different treatments.
Minimally invasive facet disease surgery
If an injection doesn’t effectively relieve the pain, the next step could be a laser facet thermal ablation, which is performed through a small tube (approximately the size of a quarter) and is a safer and effective alternative to traditional open neck or 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.
Your surgeon 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.
