Relevance of Goel′s hypothesis regarding pathogenesis of degenerative spondylosis and its implications on facet distraction surgery

Preliminary experience with lumbar facet distraction and fixation as treatment for lumbar spinal stenosis

“…Furthermore, considering that facet instability, rather than disc degeneration, could be the primary pathogenic factor that initiates a cascade of events, ultimately resulting in spinal canal stenosis,[ 14 ] facet distraction and fixation aims not only in maintaining spinal stability but also in reversal of several pathological events in the lumbar spine that are associated with degenerative/spondylotic lumbar canal stenosis. [ 14 15 ]…”

Vertical facetal instability: Is it the point of genesis of spinal spondylotic disease?

“…In the year 2010, we proposed an alternative method of treatment of single- and multilevel cervical radiculopathy and myelopathy and lumbar canal stenosis. [ 5 6 7 8 9 ] The treatment involved distraction of the facets and introduction of intra-articular spacers. The surgery was aimed at distraction arthrodesis of the spinal segment.…”

Retro-odontoid mass: An evidence of craniovertebral instability

“…Disc space reduction is secondary effect of the primary vertical instability of the spine. [ 5 6 7 8 9 ] Essentially it means that instability is the primary event and other physical, morphological musculoskeletal, disc, and even neural alterations are secondary effects. The primary pathology is instability that may not be obvious in the subaxial spine due to oblique profile of the facets and the difficulty in radiologically viewing them.…”