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When to consider facet syndrome surgery

Facet syndrome surgery, also referred to as facet disease surgery, is usually performed in certain situations when conservative treatment has been fully pursued and symptoms remain debilitating. Since nonsurgical treatments are typically very effective in managing the symptoms of facet syndrome, many patients do not require surgery. For those who have exhausted conservative treatments, surgical intervention can provide a chance for overcoming the symptoms of a degenerative spine condition like facet syndrome.

If you’ve already tried conservative treatment and have not found relief from your facet syndrome symptoms, you may be recommended for spine surgery. It’s important to understand that there are many different types of spine surgery available, so you should research your options in order to make an informed decision about your treatment.

Open spine facet syndrome surgery

One surgical option for patients who have been diagnosed with facet syndrome is traditional open spine surgery. This type of surgery is performed in a traditional hospital setting and a patient should expect to remain hospitalized for several days after the procedure for observation.

During an open spine procedure, a large initial incision must be made and the surrounding muscles, ligaments and other soft tissues that help support the neck or back must be carefully cut to allow the surgical team access to the deteriorated facet joint. Depending on the extent of the facet joint issue, the vertebral segment might be stabilized using bone grafts and surgical implants to prevent painful joint movement in the future. Following surgery, the entry point is closed and the patient begins the recovery process.

The inherent difficulty with traditional open spine surgery is that it is major surgery and, as with any form of major surgery, there is a risk of postsurgical complications. Furthermore, the nature of the open spine approach is highly invasive, which means that even if the surgery is a complete success, the patient will have a relatively lengthy recovery and rehabilitation process to get back to full strength.

In some instances, including situations where spinal degeneration is severe or spread across several segments of the spine, open spine facet syndrome surgery is the prudent choice. However, for many other patients, there is another direction that warrants exploration.

Minimally invasive facet syndrome surgery

At USA Spine Care, we are the leader in minimally invasive spine surgery. Our procedures are performed on an outpatient basis and involve a reduced risk of surgical complications and a shorter recovery time than traditional open neck or back surgery.^ This is because our surgeons use muscle-sparing techniques, limiting disruption of the soft tissue around the neck or back.

For patients with facet syndrome and other forms of spinal degeneration, USA Spine Care may recommend any of the following minimally invasive decompression surgeries:

  • Foraminotomy — a procedure that is designed to relieve pressure on nerves as they enter and exit the spinal column
  • Laminotomy — designed to reduce pressure on the spinal cord that develops as a result of a narrowing of the spinal canal, also known as spinal stenosis
  • Discectomy — a procedure to carefully remove herniated disc material or a bulging disc wall to relieve nerve compression
  • Facet thermal ablation — a type of facet syndrome surgery that deadens the nerve within a facet joint that has become inflamed as a result of facet arthritis

Additionally, USA Spine Care specializes in minimally invasive stabilization surgery for patients whose facet syndrome has advanced to the point that the stability of a vertebral segment is at risk. Some examples of the stabilization procedures we offer include:

  • Decompression with Interlaminar Stabilization? device — a device is placed on the lamina to open up a constricted foramen in order to decompress a spinal nerve root
  • Anterior cervical discectomy fusion — a small incision is made through the front of the neck to access a damaged disc, which is replaced with an implant, such as bone graft material or a damaged disc
  • Cervical disc replacement — a minimally invasive procedure wherein a deteriorated disc is substituted with a new artificial disc
  • Transforaminal lumbar interbody fusion — a bone graft and spacer is inserted into disc space to maintain disc height and stabilize the region of the spine
  • Lateral lumbar interbody fusion — a procedure that accesses the spine from an incision on the side of the body to avoid the need to separate low back muscles and other tissue
  • SI joint fusion — a surgery that stabilizes the area where the sacrum joints meet the pelvis in the lower torso
  • Posterior cervical fusion — a cervical fusion surgery that is performed through the back of the neck to achieve stabilization

While these procedures all vary widely on style and approach, the unifying theme is that they are all performed in an outpatient surgery center by surgeons who have dedicated their careers to minimally invasive spine surgery. These operations represent a compelling alternative to open spine surgery.

Causes of facet syndrome

Facet syndrome, also known as spinal osteoarthritis, is the natural deterioration of the facet joints in the spine that is associated with getting older and normal wear and tear over the years. As part of the aging process, the facet joints gradually lose their protective articular cartilage. This deterioration may progress to the point that bone rubs against bone, causing significant inflammation. Inflammation also stimulates the formation of bone spurs, which are excess bony growths on the articular margins of facet joints. These smooth protuberances are harmless on their own and only become symptomatic if they compress a nearby spinal nerve or other soft tissue. It is this “pinching” that causes symptoms, not the bone spurs themselves.


The most common symptoms associated with facet syndrome include:

  • Pain and stiffness at the site of bone-on-bone contact or at the site of a pinched nerve
  • Pain that radiates along the length of a compressed nerve root
  • Muscle weakness
  • Numbness
  • Tingling

Treatment options

Again, facet syndrome surgery is typically an elective procedure that is considered only if conservative treatments have not provided you with significant pain relief. Physical therapy, pain medication, hot and cold therapy and other nonsurgical choices are usually sufficient for many patients. However, if several weeks or months of conservative treatment lead to little or no improvement, contact USA Spine Care.

We will be glad to provide a free MRI review* to help you find out if you are a potential candidate for one of our procedures.

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