A Patient Education Guide
Introduction
If you suffer from spinal (back) pain, especially in the low back or neck, and non-surgical treatments like physical therapy, medications, or injections have not provided adequate relief, your doctor might recommend percutaneous facet joint fusion. This minimally invasive procedure targets pain originating from the facet joints, which are small joints in the spine that allow for movement and flexibility but can also become a source of chronic pain when damaged or degenerated.
This guide will explain percutaneous facet joint fusion, how it works, the conditions it treats, the benefits, risks, recovery expectations, and more. By the end of this article, you should have a better understanding of whether this treatment might be the right option for you.
At Endoscopic & Minimally Invasive Spine Specialists, we have extensive experience and expertise in percutaneous facet joint fusion and provide the highest-quality care in surgical and non-surgical spine care.
To learn more about percutaneous facet joint fusion surgery, call the office today or request an appointment online.
This guide will help you understand the condition, the procedure, its benefits, risks, and the recovery process.
What is the Facet Joint?
The facet joints are small joints located along the sides and between the vertebrae in your spine. They are responsible for stabilizing the spine and allowing flexibility and smooth movement, such as bending or twisting. Each vertebral body below C2 in the spine has two pair of facet joints – one on each side facing up (superior), and one on each side facing down (inferior) – that form a connection with the vertebra above and the vertebra below. These joints are critical for maintaining normal spinal motion and supporting the weight of the body.
Over time, however, these joints can become damaged due to aging, wear and tear, or focal injury, leading to conditions such as facet joint arthritis, degeneration, or spondylolisthesis. When these joints become inflamed or arthritic, they can cause significant pain in the back or neck, radiating pain to the hips, buttocks, or legs. This is sometimes known as facet joint syndrome, and may cause radiculopathy or nerve root compromise, and it can result in discomfort and stiffness.
What is Percutaneous Facet Joint Fusion?
Percutaneous (posterior) facet joint fusion is a minimally invasive procedure designed to treat pain caused by facet joint dysfunction or degeneration. The goal of the procedure is to fuse two or more vertebrae together at the facet joints, which stabilizes the spine and prevents the joint from moving. By eliminating painful movement, facet joint fusion can significantly reduce or completely eliminate that pain and remarkably improve quality of life for patients suffering from chronic spinal issues.
“Percutaneous” refers to the technique of accessing the facet joint through small incisions in the skin, rather than through large open surgery. This approach is less invasive, requires less recovery time, and has a lower risk of complications compared to traditional fusion surgery. Percutaneous facet joint fusion is often performed using image guidance, such as X-rays or CT scans, to precisely locate the joint and ensure proper placement of the fusion materials.
Conditions Treated by Percutaneous Facet Joint Fusion
Percutaneous facet joint fusion is typically recommended for patients who have back or neck pain originating from facet joint problems that have not responded to non-surgical treatments. Some of the conditions that can be treated with percutaneous facet joint fusion include:
- Facet Joint Arthritis: This is one of the most common causes of pain in the facet joints. It occurs when the cartilage that cushions the facet joints wears down, leading to inflammation, pain, and stiffness.
- Degenerative Disc Disease: When the discs between the vertebrae begin to degenerate and lose their cushioning ability, it can place additional stress on the facet joints, causing pain.
- Spondylolisthesis: This condition occurs when one vertebra slips forward over the vertebra below it, which can strain the facet joints and lead to pain.
- Spinal Stenosis: A narrowing of the spinal canal, which can compress nerves and cause pain in the back, legs, or other parts of the body.
- Instability in the Spine: Certain conditions or injuries can cause the spine to become unstable, putting excessive strain on the facet joints, leading to pain.
- Foraminal stenosis: A narrowing of the bony window where the nerve root exits the spinal column. When this space is reduced, it can cause compression of that exiting nerve and cause pain that radiates into the arm or leg, called radiculopathy.
Facet joint pain can be a significant source of discomfort, especially if it becomes chronic. When conservative treatments such as physical therapy, medications, injections, and lifestyle changes fail to provide relief, percutaneous facet joint fusion may be considered as a solution.
How Percutaneous Facet Joint Fusion Works
The percutaneous facet joint fusion procedure aims to stabilize the spine by fusing two or more vertebrae together at the facet joint level. Here’s a step-by-step explanation of how the procedure works:
1. Preoperative Planning: Before the surgery, your doctor will conduct a thorough evaluation of your medical history and symptoms, along with diagnostic imaging (such as X-rays, MRI, or CT scans) to identify the precise location of the facet joints that are causing pain.
2. Anesthesia: The procedure is typically performed under local anesthesia combined with sedation, which means you will be awake but relaxed and comfortable during the procedure. You may also receive regional anesthesia, where the area around the spine is numbed, to minimize discomfort.
3. Small Incision: The surgeon will make one or two small incisions (about 1-2 cm in length) near the affected facet joints. These incisions are small enough that no stitches are typically required afterward, and the procedure is much less invasive than traditional spinal surgery.
4. Insertion of Surgical Instruments: Using fluoroscopy (a type of real-time X-ray), the surgeon will guide special surgical instruments through the small incisions to the targeted facet joint. The surgeon will also use a hollow needle to insert a bone graft or biological material that promotes fusion. In some cases, screws or plates may also be used to stabilize the joint.
5. Fusion Process: Once the bone graft or fusion material is placed, the adjacent vertebrae will eventually heal together (fuse), eliminating movement at the facet joint and reducing pain. Over time, the body will naturally create new bone tissue to join the vertebrae and complete the fusion process.
6. Closure: After the fusion materials are in place, the surgeon will remove the instruments and close the incisions with a small bandage. No stitches are typically required, and the procedure is complete.
Benefits of Percutaneous Facet Joint Fusion
There are several advantages to choosing percutaneous facet joint fusion over traditional open surgery. These benefits include:
– Minimally Invasive: The small incisions mean less trauma to surrounding tissues, reduced muscle damage, and a quicker recovery.
– Reduced Pain: Most patients experience significant relief from chronic back pain, as the fusion stabilizes the facet joint and eliminates painful movement.
– Faster Recovery: Because the procedure is less invasive, the recovery time is generally shorter than traditional fusion surgeries. Most patients can return to light activities within a few days to weeks.
– Lower Risk of Complications: The procedure has a lower risk of infection, bleeding, and nerve damage compared to open spine surgery.
– No Need for General Anesthesia: The procedure is typically done with local anesthesia and sedation, meaning you avoid the risks associated with general anesthesia.
– Minimal Scarring: Since the incisions are small, scarring is minimal and typically barely noticeable.
Risks and Complications
While percutaneous facet joint fusion is a relatively low-risk procedure, it does come with some potential risks and complications, including:
– Infection: Any surgical procedure carries a small risk of infection at the incision site.
– Nerve Damage: Although rare, there is a possibility of nerve injury during the procedure, which could lead to symptoms such as numbness, weakness, or tingling in the legs or back.
– Bleeding: Some bleeding is possible, though it is usually minimal in percutaneous procedures.
– Nonunion: In some cases, the vertebrae may not fuse properly, and the bone graft may fail to achieve solid union. If this happens, additional treatment may be required.
– Pain Recurrence: While fusion can be effective at providing long-term pain relief, some patients may continue to experience pain or require further procedures if the fusion doesn’t take or if new problems develop.
Recovery After Percutaneous Facet Joint Fusion
Recovery after percutaneous facet joint fusion is generally quick compared to traditional spine surgeries. Here’s what you can expect:
1. Immediate Post-Procedure Care: After the procedure, you may experience some discomfort or soreness at the incision sites, but this can usually be managed with over-the-counter pain medications.
2. Activity Restrictions: In the first few days, you will be advised to avoid heavy lifting, twisting motions, or other strenuous activities that could stress the spine. Light walking and gentle movements are encouraged to promote healing.
3. Follow-Up Appointments: You will have follow-up appointments with your surgeon to monitor your progress, check for complications, and ensure that the fusion is progressing as expected. X-rays or other imaging tests may be used to assess the healing process.
4. Physical Therapy: Depending on your recovery, your doctor may recommend physical therapy to help strengthen the muscles around the spine and improve mobility.
5. Full Recovery: Full recovery from percutaneous facet joint fusion can take anywhere from 6 weeks to 3 months. During this time, it’s important to follow your doctor’s recommendations to ensure proper healing and avoid complications.
Long-Term Outlook
Most patients experience significant pain relief and improvement in function after percutaneous facet joint fusion. However, the success of the procedure depends on various factors, including the extent of the degeneration in the facet joints, the patient’s overall health, and their adherence to post-operative care instructions.
Some patients may require repeat procedures if pain recurs, but for many, the procedure offers long-lasting relief and enables them to return to normal activities with reduced pain.
Conclusion
Percutaneous facet joint fusion is a highly effective, minimally invasive treatment for patients suffering from chronic back or neck pain caused by facet joint dysfunction. It offers numerous benefits, including reduced pain, faster recovery, and fewer complications compared to traditional spinal surgery. If you have chronic facet joint pain and have not found relief with other treatments, percutaneous facet joint fusion may be a viable solution to help you regain your quality of life. Be sure to discuss your symptoms and treatment options with your healthcare provider to determine whether this procedure is right for you.
To learn how you can benefit from percutaneous facet joint fusion and patient-centered care for your spinal problems, call Endoscopic & Minimally Invasive Spine Specialists today, or book an appointment online.
