Learning objectives
- To focus on anatomy and bio-mechanics of the interapophyseal joints,
their innervation and potential involvment as one of the many - and frequently misdiagnosed - causes of back pain.
- To expose how facet syndrome can be managed and treated by the Interventional Radiologist,
showing the state-of-the-art of the available techniques for percutaneous treatment and technical aspects of their execution.
Main
Background
Facet syndrome has high prevalence in elderly populations,
because of their frequent arthritic degeneration of the interapophyseal joints in conditions of chronic overload,
sometimes associated with repeated microtrauma.
Less frequently facet syndrome is associated to synovitis with fluid distension of the articular capsule (which might be caused by microtrauma,
inflammatory aspecific reactions or their rheumatological involvement),
entrapment of meniscoid articular structures,
synovial impingement,
subluxation,
chondromalacia,
expansive processes and other rarer causes.
Clinical diagnosis of facet syndrome is not straightforward,
bacause of its clinical presentation,...
References
[1] M.
Gallucci,
N.
Limbucci,
S.
Marcia,
A.Ricci (2011) Interventistica articolare del rachide in Caudana,
Genovese,
Masciocchi (ed) Radiologia Interventstica Muscolo-scheletrica,
Elsevier-Masson,
Milano pp.180-208.
[2] Schwarzer AC,
Aprill CN,
Derby R,
Fortin J,
Kine G,
Bogduk N (1994) Clinical features of patients with pain stemming from the lumbar zygapophysial joints: is the lumbar facet syndrome a clinical entity? Spine 19:1132–1327.
[3] S.Marcia,
S.Masala,
M.Marras,
A.Cauli "Treatment of facet joints" in Interventional Spine Radiology,Clinical Features,
Diagnosis and Therapy
Muto,
Mario (Ed.)2013.