Facet Fusion
What Is Facet Fusion?
A facet fusion is a surgical option available for patients with chronic back pain due to facet joint syndrome or spinal arthritis. With this procedure, the vertebrae in the painful area are fused together to stop joint movement. Eliminating joint movement stops the pain.
What are Facet Joints?
The facet joints of the spinal column are two joints between each of the 24 non-fused vertebrae that form the spine. These joints have a disc between them, and they are surrounded by fibrous ligaments. The facet joints are small, containing tiny amounts of synovial fluid that lubricates them for joint movement. With injury, aging, or damage, these joints can become painful and inflamed, particularly when the loss of lubrication creates too much friction.
What Is Facet Joint Syndrome?
Facet joint syndrome is a back-pain condition in which an arthritic facet joint causes pain and stiffness, can reduce flexibility, and make it harder for you to perform your routine daily tasks. Facet joint syndrome can be caused by aging, un-diagnosed osteoarthritis, or prolonged alcohol and tobacco use. Facet joint syndrome is most common in the lumbar region of the spine, but can still affect the cervical, thoracic, or sacral vertebrae.
Who Is a Candidate for a Facet Fusion?
To find out if you're a candidate for facet fusion, a consultation with a spinal surgeon is needed. Patients who have been diagnosed with facet joint syndrome, osteoarthritis, mild to moderate degenerative disc disease, or spondylolisthesis where conservative back pain treatments have not provided relief may be eligible for facet fusion. These conservative treatment methods include anti-inflammatory drugs, corticosteroid injections, muscle relaxants, and pain medicine.
In addition, you must have attempted physical therapy, spinal manipulation, and traction for pain relief. Certain patients may not be eligible for a facet fusion, such as people with uncontrolled diabetes, those with a bleeding disorder, individuals with severe degenerative disease of the discs and vertebrae, and persons with an active infection.
The Facet Fusion Procedure
After administering general anesthesia, the physician will clean the skin near the affected vertebrae. Using a local anesthetic, the skin and deeper tissues are numbed, which offers post-operative pain relief. A small incision is made on the skin of the area, and the doctor creates a channel used to access the bones. He then removed the damaged disc portions and replaced them with bone graft material. The joints are fused together using the disc material, which stabilizes the spine. The surgeon closes the incision using sutures or steri-strips, and a bandage is applied over the area.
What Are the Benefits of Facet Fusion Surgery?
Facet fusion is a minimally invasive procedure and does not often result in complications such as bleeding, nerve damage, or infection. With minimally invasive spinal surgery techniques used, patients experience a quicker recovery. After fusing the facet joints there will be no further mobility or motion in this area, so joint pain is alleviated. Fusion provides the relief needed, which allows patients to go about usual activities.
Another benefit of this surgery is that the facet fusion only takes 45 to 60 minutes to perform. Most patients only have to stay one night at the hospital. Because there is little muscle or tissue manipulation, rehabilitation is not painful or lengthy.
Preparing for Facet Fusion Surgery
For any spinal surgery, there are many things you can do to prepare for your procedure to be ready for the surgery itself and your recovery period. Beyond the items listed in our back surgery planning guide, there are specific things you'll need to prepare before your facet fusion.
Because you will need to recover after the procedure, you should do the following:
- Arrange to have a shower chair
- Install handrails on the stairways
- Remove all loose rugs from floors.
- Arrange to have someone stay with you for a few nights after you come home from the hospital
- Have plenty of pre-made meals and water available
Before your procedure, you must fast for 8 hours. You can have your usual medications with a small sip of water. Also, ensure you notify the doctor if you are taking any agents that thin the blood.
How Effective is Facet Fusion Surgery?
In a recent radiological follow-up study, researchers assessed the efficacy and safety rates associated with instrumented facet fusion of the lumbar and lumbosacral spine regions. The clinical study involved 99 people with degenerative disc disease who had been treated conservatively for more than 2 years.
The researchers found that after facet fusion, the 2-year success rate was 96%, with a 99% efficacy rate for one-level fusion procedures. Overall, the procedure was found to be a safe, simple, and effective option for the treatment of patients with degenerative spondylolisthesis and other spinal disorders.