Spine Disorders
TREATMENT OPTIONS There are
multiple treatment approaches available for individuals with facet syndrome.
These include a multitude of conservative approaches ranging from chiropractic
care to local injections, radiofrequency ablation of the facet joint to
surgical fusion of the bones (in extreme cases). If the
symptoms are limited to pain with movement (mechanical pain) a conservative
approach is usually beneficial. This may include:
In cases of chronic facet joint
syndrome that does not respond to an appropriate course of conservative care
alternative treatment approaches are available. One of these approaches is
called a Radiofrequency Rhizotomy. The procedure should be performed by a skilled
pain management physician with experience in this type of procedure. There are small
nerves that arise from the facet joints which carry the painful impulses to the
brain. This transmission of the pain signals from these nerves can be blocked
by heating the nerves using focused radiofrequency waves. The pain relief from
this procedure usually lasts around 6 months to 2 years. Severe facet
arthropathy and related bone spurring can cause narrowing of the neuroforamen,
a term referring to the openings on either side of the spine where the spinal
nerves exit. If the nerve becomes
compressed a surgical procedure called a foraminotomy many be required to take
pressure off of the nerve and provide more space around the nerve. Severe facet
arthropathy can lead to excessive movement of the involved spinal segment. This
occurs secondary to a loss of disc volume, thinning of the facet joint space
and loss of support from degenerative surround ligaments. The extra spinal
segment movement is often referred to as hypermobility, instability and/or
spondylolisthesis depending on the degree and pattern of involvement. If the
condition and related symptoms can not be managed adequately with conservative
methods surgical stabilization (fusion) of the involved segment may be
nessecary. This should always be a last resort. |