The Internet Journal of Minimally Invasive Spinal Technology™ ISSN: 1937-8254

The Internet Journal of Minimally Invasive Spinal Technology is the official online journal of ISMISS/SICOT (International Society of Minimally Invasive Spinal Surgery, affiliate of SICOT) and AAMISMS (American Academy of Minimally Invasive Spine Surgery and Medicine)

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The Lumbar Facet Syndrome

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V. Radchenko MD
Sytenko Institute Of Spine And Joint Pathology

Citation: V. Radchenko : The Lumbar Facet Syndrome. The Internet Journal of Minimally Invasive Spinal Technology. 2009 Supplement II - to IJMIST Vol III No 4

Abstract

Introduction: The lumbar facet syndrome is encountered most frequently, it follows that possible ways of its treatment are particularly important. Purpose: Estimation of possibilities of diagnostics and treatment of patients with a lumbar facet syndrome Materials and methods: We used morphological material of 56 facet joints of the lumbar spine taken in the course of the operation of the posterior lumbar interbody fusion on levels L4-5 and L5-S1 for various structural and functional disorders of the lumbar spine; 52 arthrograms of the facet joints. Results of intra-articular blockades (518 patients), data about 428 patients having lumbar facet syndrome which underwent mini-invasive surgical treatment including denervation and percutaneous arthrodesis. 201 patients were treated by way of denervation through electro-coagulation (1-st group) and 211 by way of cryo-destruction (2-nd group). Percutaneous arthrodesis was performed in 16 patients. The results were evaluated by Oswestry scale. Results: Morphological investigation demonstrated the whole range of changes characteristic for the synovial joints. By data of the articular arthrography the picture peculiar to instability, severe arthrosis was determined. In 3 cases diverticuli of the upper turn of the facet joint markedly influencing the formation of clinical symptoms were identified. The results of the intra-articular blockades in the intra-articular group were good - 65%, satisfactory - 33%, unsatisfactory - 2% . In the para-articular group they were good - 58%, satisfactory – 35%, unsatisfactory - 7%. In the course of comparative analysis of the results in first and second group facet denervation we could find significant difference in favor of cryo-destruction. Among the patients with the percutaneous arthrodesis performed 15 patients had good result and in 1 patient the condition was not changed. Conclusion: Variable changes of the facet joints of the lumbar spine play a significant role in the formation of pain syndrome and their diagnostics and treatment demand a special consideration. Application of active tactics in the treatment of the lumbar facet syndrome makes it possible to achieve good results.

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	The Internet Journal of Minimally Invasive Spinal Technology™ ISSN: 1937-8254 \| Home \| Editors \| Current Issue \| Archives \| Instructions for Authors \| Disclaimer \| Share with others \| The Internet Journal of Minimally Invasive Spinal Technology is the official online journal of ISMISS/SICOT (International Society of Minimally Invasive Spinal Surgery, affiliate of SICOT) and AAMISMS (American Academy of Minimally Invasive Spine Surgery and Medicine) The Lumbar Facet Syndrome Read printer friendly Subscribe in a reader Share with others V. Radchenko MD Sytenko Institute Of Spine And Joint Pathology Citation: V. Radchenko : The Lumbar Facet Syndrome. The Internet Journal of Minimally Invasive Spinal Technology. 2009 Supplement II - to IJMIST Vol III No 4 Abstract Introduction: The lumbar facet syndrome is encountered most frequently, it follows that possible ways of its treatment are particularly important. Purpose: Estimation of possibilities of diagnostics and treatment of patients with a lumbar facet syndrome Materials and methods: We used morphological material of 56 facet joints of the lumbar spine taken in the course of the operation of the posterior lumbar interbody fusion on levels L4-5 and L5-S1 for various structural and functional disorders of the lumbar spine; 52 arthrograms of the facet joints. Results of intra-articular blockades (518 patients), data about 428 patients having lumbar facet syndrome which underwent mini-invasive surgical treatment including denervation and percutaneous arthrodesis. 201 patients were treated by way of denervation through electro-coagulation (1-st group) and 211 by way of cryo-destruction (2-nd group). Percutaneous arthrodesis was performed in 16 patients. The results were evaluated by Oswestry scale. Results: Morphological investigation demonstrated the whole range of changes characteristic for the synovial joints. By data of the articular arthrography the picture peculiar to instability, severe arthrosis was determined. In 3 cases diverticuli of the upper turn of the facet joint markedly influencing the formation of clinical symptoms were identified. The results of the intra-articular blockades in the intra-articular group were good - 65%, satisfactory - 33%, unsatisfactory - 2% . In the para-articular group they were good - 58%, satisfactory – 35%, unsatisfactory - 7%. In the course of comparative analysis of the results in first and second group facet denervation we could find significant difference in favor of cryo-destruction. Among the patients with the percutaneous arthrodesis performed 15 patients had good result and in 1 patient the condition was not changed. Conclusion: Variable changes of the facet joints of the lumbar spine play a significant role in the formation of pain syndrome and their diagnostics and treatment demand a special consideration. Application of active tactics in the treatment of the lumbar facet syndrome makes it possible to achieve good results. This article was last modified on Fri, 03 Jul 09 14:16:49 -0500 This page was generated on Sat, 20 Mar 10 08:12:39 -0500, and may be cached.
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