Indications for Facet Joint Surgery

Facet Joint Surgery

Facet joint surgery is an invasive treatment reserved for severe chronic facet joint syndrome symptoms. Facet syndrome is a degenerative condition which affects the spinal facet joints. It is also is a controversial diagnosis, since many doctors consider it a normal and universal part of the aging process.

The majority of patients with facet joint degeneration do not have pain and should not expect pain to occur. Research shows no link between the incidence of chronic dorsalgia and the virtually universal demonstration of facet arthrosis.

However, in particular circumstances, joint degeneration can become problematic and may be uncomfortable or even downright torturous to endure. When these cases do not respond to more conservative care, surgery is often suggested.

This article will focus on surgical interventions used to resolve spinal pain issues thought to be caused by facet joint syndrome.


Facet Joint Surgery Procedures

Back surgery for facet joint problems is not common. Severe cases of facet joint pain are sometimes treated with a laminectomy and often, an add-on foraminotomy. These procedures are typically very invasive and will force the patient to endure a long and painful recovery period.

Extreme cases of facet joint syndrome are sometimes treated with spinal fusion surgery. This is perhaps the most invasive of all spinal surgeries. All efforts should be taken to bypass any surgery for facet joint pain and spinal fusion should be avoided at all costs, except in the most dire of scenarios.

Of course, the procedure selected will be determined by the suspected mechanism for pain. The above are usually used when there is reason to suspect significant neurological involvement, such as bone spurs greatly narrowing the neuroforaminal spaces and impinging on a nerve root, in addition to the mechanical pain endured due to facet deterioration.


Alternatives to Facet Joint Syndrome Surgery

Only a few patients with confirmed facet joint pain can be successfully treatment non-surgically. Even those stubborn facet joint symptoms which resist conservative treatment can usually be alleviated with either epidural injections, spinal decompression or a minimally invasive procedure, such as facet rhizotomy.

There are also other minimally invasive techniques which may not address the degeneration directly, but can make the affected areas stop hurting long-term or even permanently.  A variety of nerve blocking techniques is used for this express purpose.

Remember that physical back pain usually responds well to appropriate medical treatment. Symptoms that remain unresolved despite many varied therapy attempts might be the result of a psychogenic back pain condition.  In order to cover this possibility, a comprehensive knowledge therapy program should be included into the patient’s back care regimen.


Facet Joint Surgery Cautions

Although surgery is not used as often for facet joint pain as for most other spinal conditions, it is still prescribed for some patients. Before even considering surgery, a patient should usually completely exhaust all enlightened conservative therapy options.

Spinal decompression is one of the newer approaches used to relieve facet joint pain. Although results are not as good as the symptom relief provided to disc problems, spinal decompression is still relatively effective and is non-invasive.

If surgery is the right treatment for your facet syndrome symptoms, make sure to find an experienced surgeon who has demonstrated good operative results. Like all things in life, surgeons are not created equal, so if you must endure a surgical procedure, be sure to hire the very best you can find.  Also, remember to learn about your many different choices for invasive procedures, since your choice will have a significant outcome on your results.



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