Medial Facetectomy

Medial Facetectomy

A spinal procedure intended to relax pinched spinal nerve roots by partially removing one or both calcified facet joints on a set of vertebrae.

What is a Medial Facetectomy?

  • Frees up spinal nerves being pinched by degenerated facet joints that have slipped.
  • Alleviates a variety of symptoms from facet joint syndrome, a spinal condition that involves deteriorated facet joints rubbing against spinal nerves.
  • One or both of the facet joints are only partially removed to relieve the compression. The procedure is sometimes combined with a laminotomy and/or a foraminotomy, which removes a small amount of irregularities in the foraminal canal.
  • A medial facetectomy may also be combined with a microdiscectomy or discectomy. Rarely is a fusion performed as well, since stability usually isn't an issue with partial facet joint removal.
  • Procedure is minimally-invasive.

Medial facetectomy is a spinal procedure that partially removes one or both of the facet joints on a set of vertebrae. The procedure intends to decompress the spinal nerves being pinched by degenerated facet joints. Patients requiring medial facetectomy have facet joint syndrome, which means the cartilage around their facet joints have worn down. These joints normally help with the spine's range of motion and aid the patient's ability to bend, twist, and stand up. Patients with facet joint syndrome have worn down facet joints rub against the spinal nerves, causing pain and other debilitating symptoms.

Patients with other spinal conditions like degenerative disc disease and spondylosis are usually at high risk for also developing facet joint syndrome. The facet joints may also become susceptible to breaking down from aging, sudden trauma, injuries, recurring physical activity, and daily wear and tear. Patients may have facet joint syndrome and may not experience symptoms, but usually the first sign of the spinal condition is pain of varying strengths and difficulty walking, standing, or sitting.

Medial facetectomy is only recommended once pain persists after conservative methods of treatment have failed. Pain may come and go, or be chronically steady after 3 to 6 months. Sometimes the pain may radiate from the neck or back and into the patient's extremities, which may limit motor functions. Medial facetectomy aims to remedy this pain, but may require physical therapy as part of the recovery process.

What does it treat?

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

Who are good candidates?

While patients may have different spinal conditions, ideal candidates for medial facetectomy must have facet joint syndrome and experience pain. Candidates should also experience one or more of the following symptoms:

  • Pain that may be mild to severe, whether acute or chronic, and can be dull, sharp, deep, constant, throbbing, shooting, or radiating
  • Limited ability to perform daily activities
  • Radiating pain that travels from the neck and into the shoulders, arms, hands, and/or fingers
  • Pain that radiates from the back and into the buttocks, legs, calves, feet, and/or toes
  • Trouble walking, sitting, or standing
  • Weakness, numbness, or tingling sensation felt in the back, neck, or extremities
  • History of attempting conservative methods of treatment that were unsuccessful in remedying pain and healing the patient's spinal conditions

Patients should also acknowledge that physical therapy may be needed as part of their recovery process, and are optimistic towards pain improvement and effective pain management.

What is the procedure like?

Medial facetectomy normally takes between 1 to 2 hours to complete, depending on complexity. The patient's surgeon carries out the procedure, and the patient will be under local or general anesthesia.

These are the usual steps of the medial facetectomy procedure:

  • The surgeon preps the patient's skin for the incision, typically between 1 to 2 inches. Next, the area of the spine is exposed by separating the skin and muscles.
  • A laminotomy may now be performed to reach the facet joints. Next, a minimal amount of one or both facet joints on a set of vertebrae are removed to decompress the pinched spinal nerves.
  • A microdiscectomy or discectomy may now be carried out. If needed, a foraminotomy may now be performed as well.
  • The nerve roots should now be relaxed, and the surgeon ends the procedure by closing the incision with sutures.