The Bonati Institute Glossary: Facet Disease

The mission of The Bonati Institute is to provide hope to people suffering with chronic pain from a back or neck condition. We believe that a well-informed patient is vital to restoring hope and finding answers to pain. We developed this web site primarily to help educate pain sufferers and their families. We’ve found that the more individuals in pain learn about their anatomy, their condition and the options available to them the more likely they will be to choose the advanced arthroscopic procedures offered by The Bonati Institute.

Facet Disease

The facet joints are the smooth, flat surfaces of the vertebrae that interlock and allow the spine to flex yet still maintain its stability. The facet joints permit gliding movements between the vertebrae. There are two facet joints between each vertebrae located on each side of the vertebrae. Facet disease can occur at any level of the spine, but is most common in the lower back (lumbar) region. There are a number of terms that are used to diagnose facet problems such as facet arthritis, facet joint syndrome, facet disease, facet hypertrophy and degenerative facet joints. In general, all of the terms mean pretty much the same thing—arthritis or degeneration of the facet joint.

Facet disease is caused by the cartilage in the joints being worn down as a result of wear and tear, aging, injury or misuse. Another cause of facet disease is spondylolithesis, which is when one vertebra, usually in the lumbar spine.

When the facet joints become inflamed due to injury or age the result is stiffness and/or pain. As the facet joints deteriorate, they also might not align properly which can cause pain. Additionally, rubbing on the joints wears out the cartilage and fluid that lubricates them. As a result, bone can rub on bone, which results in painful back problems.

The facets are compressed when an individual leans backward or to the side, so someone with a facet problem would more than likely feel pain in those positions. Leaning to the front reduces the stress on the facets, so a person with a facet problem would probably find relief in that position. Some experts believe that facet pain can weaken the muscles that help to strengthen the spine, which can lead to instability. Among the problems that affect facets are facet syndrome, facet disease and facet arthritis.

Probable Treatment

The Bonati Arthroscopic Laser Facet Debridement

Facet disease can be effectively treated with a procedure called a Facet Debridement. Debridement is the surgical removal of torn, inflamed, damaged or dead tissue. Through minimally invasive spinal surgery, the physicians at The Bonati Institute perform facet debridement by using arthroscopes and lasers to vaporize irritated and painful nerves around the facets of the vertebrae. The Bonati Procedure uses specially designed probes and the Holmium YAG Laser to remove pain-inducing tissue in nerve branches above and below the affected facet joints on the spine. After a small incision is made, a tiny fiber optic camera is used to visualize the exact problem area and a laser is used to vaporize the painful nerves around the affected area. The Bonati Procedure usually takes less than 20 minutes and most patients find immediate relief from fdacet disease pain. pain.

Symptoms related to facet joint problems are usually localized to the area of the facet joint. This can occur In the cervical (neck) thoracic (mid back) and lumbar (lower back). When the facets are affected in the lumbar region, a person can experience lower back pain that can go to the buttocks and upper thigh area and can often be misdiagnosed as sciatica. If the area affected is cervical, then pain can occur in the back of the neck and radiate to the top of the shoulders, then can radiate around the neck. Pain related to facet disease can be easily diagnosed. This is accomplished by doing a diagnostic facet injection, a numbing medication injected into the facet joint.