Facetectomy

Facetectomy

A surgical technique performed to decompress impinged spinal nerve roots by removing one or both degenerated facet joints on a set of vertebrae.

What is a Facetectomy?

  • Decompresses pressure put on spinal nerves by facet joints that are irritating and pinching them.
  • The affected vertebrae are exposed; one or both of the facet joints are removed to decompress the pinched spinal nerves. The procedure is mostly combined with a laminectomy or laminotomy, which completely or partially removes the lamina bone, and with a foraminectomy or foraminotomy, which removes abnormal structures in the foraminal canal.
  • The procedure may also be combined with a microdiscectomy or discectomy, which partially or completely removes a bulging or herniated disc. Sometimes a spinal fusion is also performed, as stability may become an issue with facet joint removal.
  • Procedure is minimally-invasive.

Facetectomy is a spinal procedure that decompresses spinal nerves pinched by degenerated facet joints. The spine's facet joints usually help with the spine's mobility and help the patient bend and stand up. Sometimes the cartilage around the facet joints degenerates, and then may rub against the spinal nerves, causing pain and other debilitating symptoms. This condition is called facet joint syndrome. Removing one or both of the affected vertebrae's facet joints alleviates the pressure on the spinal nerves and the patient's pain.

Facet joint syndrome may be caused by degenerative spinal conditions like degenerative disc disease and spondylosis. Aging, injuries, sudden trauma, repetitive activity, and wear and tear may also cause the facet joints to rupture or tear. Many patients with facet joint syndrome do not realize they have the condition until they experience pain, trouble standing straight, walking, or sitting, and other symptoms.

The patient's pain may be acute, which comes and goes within 3 months, or chronic, which does not go away after 3 to 6 months. Pain may be of varying strengths, from mild to severe, and may be felt into the patient's extremities. Depending on the location of the degenerated facet joints, the pain may be felt from the neck and into the shoulders and/or arms, or in the back and into the legs and/or feet. The pain may constant, in waves, sharp, dull, and/or throbbing. Facetectomy aims to treat the pain and other symptoms by removing the offending facet joints.

What does it treat?

  • Facet Joint Syndrome
  • Degenerative Disc Disease
  • Spondylosis
  • Foraminal Stenosis
  • Pinched Nerve

Who are good candidates?

Ideal candidates for a facetectomy may have a variety of spinal conditions, but all must experience pain from facet joint syndrome. Additionally, candidates should experience one or more of the following symptoms:

  • Pain of varying strengths that is acute or chronic, and is dull, sharp, deep, throbbing, shooting, or radiating to the extremities
  • Limited motor functions
  • Pain that radiates from the back and into the buttocks, legs, calves, feet, and/or toes
  • Pain that travels from the neck and into the shoulders, arms, hands, and/or fingers
  • Difficulty standing straight, walking, or sitting
  • Weakness, numbness, or a tingling sensation felt in the back, neck, or extremities
  • Multiple attempts of conservative methods of treatment that have failed to relieve pain and heal the spinal conditions

Also, patients should be aware of any physical activity that may be part of their recovery and are positive towards pain improvement and management.

What is the procedure like?

The facetectomy is performed by the patient's surgeon, and the procedure takes between 1 and 2 hours to complete, determined by the intricacy. During the procedure, the patient will be under general anesthesia.

The following are the general steps of the facetectomy procedure:

  • The area is prepped for the incision, which is between 1 to 3 inches. Then, the skin and muscles are separated so the affected facet joints are exposed.
  • Then, the surgeon removes one or both of the deteriorated facet joints to relax the pinched nerve roots.
  • If a herniated or bulging disc is present, the surgeon may now perform a microdiscectomy or discectomy, which partially or completely removes the disc material. Other procedures, like a laminotomy or laminectomy, a foraminotomy or a foraminectomy, or a spinal fusion may also be performed.
  • Now that the nerves are decompressed, the surgeon closes the incision with sutures and the procedure ends.