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'''Facet syndrome''' is any condition in which the [[Zygapophysial joints]] ([[synovial]] [[diarthroses]], from [[Cervical vertebra 2|C2]] to [[Sacral vertebrae|S1]]) become inflamed, cause pain, or degenerate.<ref name="sibell">{{cite web|author= David M. Sibell |url=http://withtrauma.com/cervical-and-lumbar-facet-arthropathy/ |title= Cervical and Lumbar Facet Arthropathy |date=17th October, 2011}}</ref> 55% of facet syndrome cases occur in cervical [[vertebrae]], and 31% in lumbar.<ref name="sibell"/> Facet syndrome can progress to spinal osteoarthritis, which is known as [[spondylosis]]. Pathology of the C1-C2 (atlantoaxial) joint, the most mobile of all vertebral segments, accounts for 4% of all [[spondylosis]].<ref>{{cite web|author=James Halla|url=http://onlinelibrary.wiley.com/doi/10.1002/art.1780300514/abstract|title=Atlantoaxial (C1-C2) facet joint osteoarthritis}}</ref> |
'''Facet syndrome''' is any condition in which the [[Zygapophysial joints]] ([[synovial]] [[diarthroses]], from [[Cervical vertebra 2|C2]] to [[Sacral vertebrae|S1]]) become inflamed, cause pain, or degenerate.<ref name="sibell">{{cite web|author= David M. Sibell |url=http://withtrauma.com/cervical-and-lumbar-facet-arthropathy/ |title= Cervical and Lumbar Facet Arthropathy |date=17th October, 2011}}</ref> 55% of facet syndrome cases occur in cervical [[vertebrae]], and 31% in lumbar.<ref name="sibell"/> Facet syndrome can progress to spinal osteoarthritis, which is known as [[spondylosis]]. Pathology of the C1-C2 (atlantoaxial) joint, the most mobile of all vertebral segments, accounts for 4% of all [[spondylosis]].<ref>{{cite web|author=James Halla|url=http://onlinelibrary.wiley.com/doi/10.1002/art.1780300514/abstract|title=Atlantoaxial (C1-C2) facet joint osteoarthritis}}</ref> |
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The facet joints are formed by the superior and inferior processes of each vertebra |
The facet joints are formed by the superior and inferior processes of each vertebra. The [[Cervical vertebra 1|first cervical vertebra]] has an inferior articulating surface but, as it does not restrict lateral or posterior translation, is not always considered a proper zygoma<ref>{{cite web|author=Frank Netter|url=http://www.backpain-guide.com/Chapter_Fig_folders/Ch05_Anatomy_Folder/3C1C2.html|title=Atlas of Human Anatomy}}</ref><ref>Van de Graaff (2002). ''Human Anatomy.'' New York: McGraw Hill, p. 160.</ref> (''zygoma'' is Greek for "yoke," i.e. something that restrains movement). In the [[lumbar spine]], facets provide about 20 percent of the twisting stability in the low back. Each facet joint is positioned at each level of the spine to provide the needed support especially with rotation.<ref>Steven C. Ludwig, M.D., Chief of Spine Surgery, University of Maryland Medical Center January 4, 2008</ref> |
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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.<ref>Steven C. Ludwig, M.D., Chief of Spine Surgery, University of Maryland Medical Center January 4, 2008</ref> |
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.<ref>Steven C. Ludwig, M.D., Chief of Spine Surgery, University of Maryland Medical Center January 4, 2008</ref> |
Revision as of 16:24, 18 October 2011
Facet syndrome | |
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Specialty | Rheumatology |
Physiology
Facet syndrome is any condition in which the Zygapophysial joints (synovial diarthroses, from C2 to S1) become inflamed, cause pain, or degenerate.[1] 55% of facet syndrome cases occur in cervical vertebrae, and 31% in lumbar.[1] Facet syndrome can progress to spinal osteoarthritis, which is known as spondylosis. Pathology of the C1-C2 (atlantoaxial) joint, the most mobile of all vertebral segments, accounts for 4% of all spondylosis.[2]
The facet joints are formed by the superior and inferior processes of each vertebra. The first cervical vertebra has an inferior articulating surface but, as it does not restrict lateral or posterior translation, is not always considered a proper zygoma[3][4] (zygoma is Greek for "yoke," i.e. something that restrains movement). In the lumbar spine, facets provide about 20 percent of the twisting stability in the low back. Each facet joint is positioned at each level of the spine to provide the needed support especially with rotation.[5]
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.[6]
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.[7]
Associated Conditions
- Traumatic and degenerative changes
- Internal disc degeneration
- Spondylolisthesis
- Osteoarthritis
- Inflammatory arthritides
- Ankylosing spondylitis
- Rheumatoid arthritis
Diagnosis
Facet Syndrome is a common cause of low back pain. It is a low back pain syndrome attributed to osteoarthritis of the interarticular vertebrae; Clinical Low back pain that increases on extension, radiates to the posterior thigh, and ends at the knee; x-ray and CT imaging reveal narrowing of disk space, osteophyte formation.
Differential Diagnosis
- Internal disc degeneration
- Myofascial pain syndrome
- Fibromyalgia
- Inflammatory and/or autoimmune arthritides
Treatment
Treatments may include NSAIDs, intraarticular injections with anesthetics, low back fusion with osteodegeneration, and endurance training.
Surgery
- Spinal fusion with facetectomy
- Possible role for disc replacement
References
- ^ a b David M. Sibell (17th October, 2011). "Cervical and Lumbar Facet Arthropathy".
{{cite web}}
: Check date values in:|date=
(help) - ^ James Halla. "Atlantoaxial (C1-C2) facet joint osteoarthritis".
- ^ Frank Netter. "Atlas of Human Anatomy".
- ^ Van de Graaff (2002). Human Anatomy. New York: McGraw Hill, p. 160.
- ^ Steven C. Ludwig, M.D., Chief of Spine Surgery, University of Maryland Medical Center January 4, 2008
- ^ Steven C. Ludwig, M.D., Chief of Spine Surgery, University of Maryland Medical Center January 4, 2008
- ^ Steven C. Ludwig, M.D., Chief of Spine Surgery, University of Maryland Medical Center January 4, 2008