Facet Joint Syndrome: Pathophysiology, Diagnosis, and Treatment

Abstract

Facet joint osteoarthritis (OA) is the most frequent form of facet joint syndrome. Medical history, referred pain patterns, physical examination, and diagnostic imaging studies (standard radiographs, magnetic resonance imaging, computed tomography and single-photon emission computed tomography) may suggest but not confirm lumbar facet joint (LFJ) syndrome as a source of low back pain (LBP). However, the diagnosis and treatment of facet joint syndrome is still controversial and needs further study. It is widely acknowledged that block with local anesthetic is perhaps the most effective method to establish a diagnosis of pain from LFJ. Particularly, there are different rates of success among different populations selected for diagnostic block with various positive criteria. Currently, in addition to conservative treatments for pain such as painkillers, functional exercises, and massage, there are many other methods, including block, denervation of the nerves that innervate the joints by radiofrequency, freezing or endoscopy, and injections. Due to the limited duration of pain relief from neurolysis of medial branch, many scholars have recently turned their targets to dorsal roots and LFJ capsules. Therefore, we reviewed the latest research progress of facet joint syndrome from diagnosis to treatment.

Expanding the ABCC-tool for osteoarthritis: Development and content validation

“…Inclusion criteria for patients were; diagnosis of OA of the hip, knee, foot, ankle, wrist, or hand, or a combination of these; being able to understand and read Dutch; and being at least 18 years old. Patients with OA localized exclusively in the neck, back, shoulder and elbow were excluded in this study, because the diagnosis of OA of the neck and back is difficult due to the lack of adequate diagnostic criteria [ 34 ], while OA of the shoulder is often accompanied by additional rotator cuff pathology [ 35 ] and OA of the elbow has a low prevalence [ 36 ].…”

The choice of pathogenetic therapy for a patient with dorsalgia: A review

“…Показано, что ОА представляет собой прогрессирующий патологический процесс, течение которого характеризуется чередованием периодов активации воспалительного процесса и формированием дегенеративного поражения хрящевой ткани [6]. Результаты экспериментальных исследований, которые проведены с оценкой объема хрящевой ткани и особенностей ее структуры, показали, что на ранних стадиях развития ОА имеет место увеличение объема хрящевой ткани, связанное в первую очередь с ее отеком [7].…”

Current Indications for Spinal Endoscopic Surgery and Potential for Future Expansion

“…Percutaneous radiofrequency ablation is a routine intervention to manage the facet-oriented CLBP refractory to medical treatment. 51 The percutaneous lesioning intervention effectively reduces pain by more than 50% in most patients. However, the duration of pain relief is 7.3-9.0 months on average after a single intervention.…”