How I do it: the biportal endoscopic inclined-ipsilateral technique to decompress the lumbar lateral recess
2
Citation
6
Reference
10
Related Paper
Citation Trend
Keywords:
Lateral recess
Facet (psychology)
Zygapophyseal Joint
Facet (psychology)
Vertebra
Pillar
Zygapophyseal Joint
Cite
Citations (0)
Facet (or zygapophyseal) joint-related pain is common in patients with a spinal disorder and occurs secondary to either facet joint wear and tear (degenerative change) or injury [1–4]. Pain secondary to facet joint pathology is not restricted to the facet joint; it can also spread to surrounding areas (i.e., referred pain) [5–7] (Fig. 4.1). Medial branch nerves are small nerves that feed out from the facet joints in the spine and transfer pain signals from the facet joints to the brain [8]. The medial branches of the dorsal rami innervate the facet joints, the posterior arches of the vertebrae, and certain spinal muscles (multifidus muscles) [9]. Of these, the facet joints are the only structure that can cause pain. Initially, a medial branch block was used to determine whether a patient's source of pain was of facet joint origin; however, several previous studies found that these blocks also reduce pain. Thus, MBNB are also used to alleviate facet joint-related pain.
Zygapophyseal Joint
Facet (psychology)
Cite
Citations (0)
Facet (psychology)
Vertebra
Pillar
Zygapophyseal Joint
Synovial joint
Cite
Citations (1)
To establish a finite element model of the fourth and fifth lumber segments in order to analyze the biomechanical characteristics of facet joints under different pressure loads.CT sectional images of L(4-5) segments were obtained to construct a finite element model, adopting contact model to simulate the condition the superior and inferior facets were in.The facet joint exhibited different performances under different conditions, and more loads was forced on it when the model was twirled.The facet joints should be simulated as in condition of contact to help correct understanding of the biomechanical characteristics of the spinal segment.
Facet (psychology)
Zygapophyseal Joint
Cite
Citations (0)
Facet (psychology)
Cite
Citations (6)
Chronic low back pain secondary to involvement of the facet joints is a common problem. Facet joints have been recognized as potential sources of back pain since 1911. Multiple authors have described distributions of pain patterns of facet joint pain. The facet joints are paired diarthrodial articulations between the posterior elements of the adjacent vertebrae. Lumbar facet joints are innervated by medial branches of the dorsal rami of the spinal nerves from the L1 to L4 levels. At L5, the dorsal ramus travels between the ala of the sacrum and its superior articular process and divides into medial and lateral branches at the caudal edge of the process. Each segmental medial branch of the dorsal ramus supplies at least two facet joints. The existence of lumbar facet joint pain claims has a preponderance of evidence, even though there are a few detractors. Multiple studies utilizing controlled diagnostic blocks have established the prevalence of lumbar facet joint involvement in patients with chronic low back pain, as ranging from 15% to 52%, based on type of population and setting studied. Long-term therapeutic benefit has been reported from three types of interventions in managing lumbar facet joint pain, including intraarticular injections, medial branch blocks and neurolysis of medial branches. This review will discuss chronic low back of facet joint origin and covers anatomy, pathophysiology, diagnosis, and various aspects related to treatment, including clinical effectiveness, cost effectiveness, technical aspects and complications.
Facet (psychology)
Zygapophyseal Joint
Back Pain
Cite
Citations (53)
Facet (psychology)
Neurotomy
Zygapophyseal Joint
Cite
Citations (0)
We performed radiofrequency neurotomy of lumbar medial branch as a treatment of facet syndrome. Our six cases had no indication for surgical therapy, such as neuralgia, spinal canal stenosis without neurological deficit except for pain and deformed spines. Facet joint injection with regional anesthetics and steroids could not prevent their recurrent back pain. By facet rhizotomy, they could obtain relief of back pain for several months to a year. We conclude that facet rhizotomy is a more effective method for facet syndrome when a proper indication is present.
Neurotomy
Rhizotomy
Lateral recess
Facet (psychology)
Zygapophyseal Joint
Spinal canal stenosis
Foraminotomy
Cite
Citations (0)
Facet (psychology)
Zygapophyseal Joint
Instrumentation
Cite
Citations (0)
BACKGROUNDChronic back pain is a common and frequent clinical presentation in any population.Presence of disc disease, facet syndrome, and vertebral body disease are usually addressed by the radiologists.Facet joints are proven to be the culprit in 15 -45 % of patients with low back pain.We wanted to compare effectiveness of fluoroscopy and computed tomography guided lumbar facet injections for pain relief in patients with facet arthropathies and mild canal stenoses. METHODSThis is a retrospective cross-sectional study performed in the Department of Radiology at our Hospital in Dhahran.This record-based study was performed in our department from Jan. 2015 -2020.All patients (N = 112) who underwent fluoroscopy and computed tomography (CT) guided facet injections (either alone or with epidural injections) for relief of chronic back pains (due to facet arthropathies and mild canal stenoses) were included, and grouped as (i) facet injections under fluoroscopy (F), and (ii) facet injections under CT guidance (C).Patients with acute disc prolapse, trauma to spine, lumbar surgeries, moderate to severe lumbar stenoses, spondylolisthesis, known systemic arthritides, those not suitable for the procedures, and those lost to follow-up were excluded.Repeat procedure within one year for recurrent complaints was used as a measure of effectiveness of the procedure.Proportional Z-test was used, and a p-value less than 0.05 was considered to be significant. RESULTSOut of a total of 112 patients, 64 were females (57 %) and 48 were males (43 %).The mean age was 56.4.Twenty out of 78 patients with facet injections under fluoroscopy and 3 out of 34 patients with facet injections under CT underwent repeat procedures (P = 0.042). CONCLUSIONSCT guided facet injections combined with epidural injections may be more effective in relief of lower back pain in patients with facet arthropathies and mild canal stenoses.
Facet (psychology)
Zygapophyseal Joint
Cite
Citations (1)