Submitted by: Patrick Foote

The most important thing for anyone to know when it comes to facet disease surgery is that it usually is considered the very last resort for the vast majority of patients with facet disease. Before surgical options are even considered for a patient with facet disease, most doctors recommend attempting to manage symptoms using a conservative treatment regimen specifically designed to meet the unique requirements of the patient. Non-surgical methods of treatment often include nonsteroidal anti-inflammatory drugs (NSAIDs), as well as exercise and stretching to improve strength and flexibility of the affected spinal segment.

Facet Disease Defined

Facet disease is a form of osteoarthritis that affects the joints where vertebrae meet and articulate. These joints are called facet joints, and they occur in pairs on either side of each vertebral segment. The ends of the facet joints are covered by a thin layer of cartilage, which can begin to wear away after years of spinal movement. The wearing-down process can be exacerbated by excess body weight or through repetitive bending, twisting, turning, and poor posture. While spinal osteoarthritis can occur at any level of the spine, it is most common in the lumbar (lower back) region, where the vertebrae are most flexible and bear the most weight.

Facet Disease Symptoms

Facet disease typically is asymptomatic in its early stages. Surgery at this stage is virtually unheard of, for the simple reason that the condition has not yet begun to have an unbearable effect on quality of life. However, spinal osteoarthritis is considered a degenerative condition, which means it can be expected to worsen over time. And once cartilage has begun to wear away, there is no way to reverse the process, because cartilage unlike soft tissue does not regenerate.

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At some point (it varies from case to case), people who develop facet disease might begin to experience the following symptoms:

Popping, cracking, or grating together of the exposed bones of the joints

Chronic back or neck pain, the location of which depends on the location of joint deterioration

Radiating pain, tingling, numbness, or muscle weakness associated with spinal nerve compression

This last set of symptoms traveling pain and other sensations caused by nerve compression is of particular concern to doctors. Patients who undergo facet disease surgery typically do so in response to debilitation related to nerve compression.

Types of Facet Disease Surgery

In general, surgery becomes an option only after conservative treatment proves ineffective over the course of several weeks or months. Once someone has determined surgery is the best way to go, there are two basic types to consider:

Facetectomy complete removal of a facet joint

Facet rhizotomy Deadening of a nerve ending in the joint with a heat source, often a laser

The first, facetectomy, is a highly invasive procedure that usually requires spinal fusion. That is, once the facet joints have been removed, metal and plastic hardware is inserted to permanently immobilize the affected vertebral segment. A bone graft may be inserted to help the two vertebrae grow together as one solid bone. This kind of surgery requires general anesthesia, hospitalization, and a long, arduous period of recuperation.

Facet rhizotomy is also is referred to as facet thermal ablation. It is a minimally invasive procedure, typically performed on an outpatient basis using a small incision and endoscopic surgical tools. No fusion hardware is necessary, because most or all of the joint structure remains intact.

Anyone considering facet disease surgery should conduct his or her own independent research, which may include getting a second opinion from another physician.

About the Author: Patrick Foote is the Director of eBusiness at Laser Spine Institute, the leader in endoscopic spine surgery. Laser Spine Institute specializes in safe and effective outpatient procedures for the treatment of

facet disease

and several other spinal conditions.

Source:

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