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Facet joint arthrosis is an intervertebral disc disorder.The facet joints or zygapophyseal joints are synovial cartilage covered joints that limit the movement of the spine and preserve segmental stability.
For example, the facet joint between T1 and T2 is innervated by C8 and T1 medial branch nerves. Facet joint between L1 and L2; the T12 and L1 medial branch nerves. However, the L5 and S1 facet joint is innervated by the L4 medial branch nerve and the L5 dorsal ramus. In this case, there is no L5 medial branch to innervate the facet joint.
Facet syndrome is a syndrome in which the facet joints (synovial diarthroses) cause painful symptoms. [1] In conjunction with degenerative disc disease , a distinct but functionally related condition, facet arthropathy is believed to be one of the most common causes of lower back pain.
Kellgren grading of cervical facet joint degeneration; Lane grading of lumbar disc degeneration; Thompson grading of lumbar disc degeneration (by magnetic resonance imaging) Pathria grading of lumbar facet joint degeneration (by computed tomography) Weishaupt grading of lumbar facet joint degeneration (by MRI and computed tomography)
The degenerative process in osteoarthritis chiefly affects the vertebral bodies, the neural foramina and the facet joints (facet syndrome). If severe, it may cause pressure on the spinal cord or nerve roots with subsequent sensory or motor disturbances, such as pain , paresthesia , imbalance , and muscle weakness in the limbs.
The articular facets, also in the posterior portion of the bony spine can become thickened and enlarged, causing stenosis. These changes are often called "trophic changes" or "facet trophism" in radiology reports. As the canal becomes smaller, resembling a triangular shape, it is called a "trefoil" canal. [citation needed]
As the two vertebrae above and below the affected disc begin to collapse upon each other, the facet joints at the back of the spine are forced to shift which can affect their function. [7] Additionally, the body can react to the closing gap between vertebrae by creating bone spurs around the disc space in an attempt to stop excess motion. [8]
DISH is diagnosed by findings on x-ray studies. Radiographs of the spine will show abnormal bone formation (ossification) along the anterior spinal ligament. The disc spaces, facet and sacroiliac joints remain unaffected. Diagnosis requires confluent ossification of at least four contiguous vertebral bodies. [2]