Facet syndrome

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Facet syndrome
Classification and external resources
ICD-9-CM 716.88, 721.0,721.3

Facet syndrome is a syndrome in which the facet joints (synovial diarthroses, from C2 to S1) cause back pain.[1]

Pathophysiology[edit]

55% of facet syndrome cases occur in cervical vertebrae, and 31% in lumbar. Facet syndrome can progress to spinal osteoarthritis, which is known as spondylosis.[2] Pathology of the C1-C2 (atlantoaxial) joint, the most mobile of all vertebral segments, accounts for 4% of all spondylosis.[3]

Facet Joints[edit]

The facet joints are formed by the superior and inferior processes of each vertebra. The first cervical vertebra has an inferior articulating surface but, as it does not restrict lateral or posterior translation, is not always considered a proper zygoma[4][5] (zygoma is Greek for "yoke," i.e. something that restrains movement). In the lumbar spine, facets provide about 20 percent of the twisting stability in the low back. Each facet joint is positioned at each level of the spine to provide the needed support especially with rotation. Facet joints also prevent each vertebra from slipping over the one below. A small capsule surrounds each facet joint providing a nourishing lubricant for the joint. Also, each joint has a rich supply of tiny nerve fibers that provide a painful stimulus when the joint is injured or irritated. Inflamed facets can cause a powerful muscle spasm.

Symptoms[edit]

Symptoms primarily manifest themselves in the lumbar spine, since the strain is highest here due to the overlying body weight and the strong mobility. Affected persons usually feel dull pain in the cervical or lumbar spine that can radiate into the buttocks and legs. Typically, the pain is worsened by stress on the facet joints, e.g. by diffraction into hollow back (retroflexion) or lateral flexion but also by prolonged standing or walking.

Diagnosis[edit]

Facet syndrome has no specific code in ICD-10. It can be diagnosed as “other” in M53.8 – other specified dorsopathies.[6]

Treatment[edit]

In general, anti-inflammatory drugs are prescribed initially. This medical treatment is usually accompanied by physiotherapy to increase back and stomach muscles. Thus, the spine can be both relieved and stabilized.[7] If these conservative measures do not bring about betterment, minimally invasive procedures such as a facet infiltration can be conducted to offer relief. In this procedure, a local anesthetic is injected directly into the respective joint, usually in combination with a cortisone preparation (corticosteroid).[8]

See also[edit]

References[edit]

  1. ^ Emedicine article on Lumbosacral Facet Syndrome
  2. ^ ICD-10 www.icd10data.com.
  3. ^ James Halla. "Atlantoaxial (C1-C2) facet joint osteoarthritis". 
  4. ^ Frank Netter. "Atlas of Human Anatomy". 
  5. ^ Van de Graaff (2002). Human Anatomy. New York: McGraw Hill, p. 160.
  6. ^ Where is the ICD-10 code for facet syndrome? www.chirocode.com.
  7. ^ Facet Syndrome www.joimax.com.
  8. ^ A. Gangi, J. L. Dietemann, R. Mortazavi, D. Pfleger, C. Kauff, C. Roy: CT-guided interventional procedures for pain management in the lumbosacral spine. In: Radiographics. 18, 1998, S. 621–633.