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Ann Rehabil Med : Annals of Rehabilitation Medicine

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"Facet joint"

Original Articles
Symptom Recurrence Pattern after Radiofrequency Thermocoagulationfor Facet Joint Syndrome.
Jho, Sun Kug , Kim, Kyung Min , Chang, Jae Hyeok , Shin, Yong Beom , Ko, Hyun Yoon , Sohn, Hyun Joo
J Korean Acad Rehabil Med 2009;33(1):94-97.
Objective
To investigate the rates and mean duration of symptom recurrence after repeated radiofrequency thermocoagulations of the lumbar medial branch nerves for facet joint syndrome. Method: Medical records of 284 patients who had consecutive radiofrequency thermocoagulations for facet joint syndrome were reviewed. Responses of repeated radiofrequency thermocoagulations were compared with the initial radiofrequency thermocoagulation for mean duration of symptom recurrence and visual analogue scale (VAS). Results: Forty-one (14.4%) among the patients who had radiofrequency thermocoagulation for facet joint syndrome were treated with additional radiofrequency thermocoagulation because of symptom recurrence. Thirty-seven patients were treated twice and four patients were treated three times. The mean duration of symptom recurrence of these patients was 7.3 months (2.3∼12.3 months). Reduction of the VAS pain scores were significantly lower after repeated radiofrequency thermocoagulations compared with initial radiofrequency thermocoagulation (p＜0.05). Conclusion: With well-defined diagnostic criteria for facet joint syndrome and a meticulous technique of radiofrequency thermocoagulation, radiofrequency thermocoagulation would be a useful treatment modality for patients with facet joint syndrome. (J Korean Acad Rehab Med 2009; 33: 94-97)
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Positioning of Lumbar Facet Joints by Analysis of Surface Anatomy in Korean Adults.
Kim, Jong Moon , Lee, Jeong Mo , Kim, Jong Hoon , Chung, Jin Sang , Choi, Young Chil
J Korean Acad Rehabil Med 2004;28(6):601-605.
Objective
To determine the Korean adult standard of mean length and depth from spinous process which is palpable landmark of back to each facet joint. Method: The horizontal line was made between the posterior end of each facet joint, and the rectangular line was made on the horizontal line at the level of spinous process, respectively. We measured the length from the point of intersection to the posterior end of each facet joint (SFL), and the depth from the tip of spinous process to the point of intersection (SFD). All parameters were measured in 30 volunteers (Exp. 1) using computed tomography and in 30 cadavers (Exp. 2). Results: The lower lumbar spine revealed the longer SFL (p＜0.01). SFD was significantly increased from L1-L2 to L3-L4 facet joints, but significantly decreased in L5-S1 facet joint compared to L4-L5 facet joint (p＜0.01). There was no significant difference in laterality, gender, and viability (Exp. 1 and Exp. 2)(p＞0.05). There was no correlation with height and weight, either (r＜0.04). Conclusion: We measured the standard for SFL and SFD in Korean. We suggest that these results will be useful in clinical practice including blind approach of spinal intervention to the facet joints. (J Korean Acad Rehab Med 2004; 28: 601-605)
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The Effects of Facet Joint Injection in Osteoporotic Spinal Compression Fractures.
Kim, Hee Sang , Yu, Seung Don , Ahn, Kyung Hoi
J Korean Acad Rehabil Med 2000;24(3):550-557.

Objective: To evaluate the effects of facet joint injection in the conservative management of osteoporotic spinal compression fractures

Method: Among 27 patients with osteoporotic spinal compression fractures which were confirmed by plain radiography and bone densitometry (dual energy x-ray absorptiometry), 9 patients were control group and 18 patients received facet joint injection treatment. Facet joint injection of thoracolumbar spine was done under fluoroscopic guide with 1% lidocaine 1 ml and triamcinolone 10 mg at each joint above and below the level of compression fracture at both side. Main outcome measures were visual analog scale (VAS), spinal movement (modified Schober's and lateral bending test), and physical activity from bed-ridden state (grade I) to outdoor activity without pain (grade V). The treatment outcomes were assessed before injection, 2 weeks and 4 weeks after injection.

Results: There were significant decrease in VAS at 2 weeks and 4 weeks after injection in the study group (p＜0.05). Physical activity was significantly improved at post injection 2 weeks and 4 weeks (p＜0.05). There were no significant differences between the two groups in spinal movement.

Conclusion: These results suggest that facet joint injection of thoracolumbar spine is useful method in the conservative management of painful osteoporotic compression fractures.

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Follow-Up MRI of Lumbar Facet Joint Orientation in the Patients with Herniated Lumbar Intervertebral Disc Treated Operatively and Conservatively.
Min, Seong Ki , Kim, Hee Sang , Ahn, Kyung Hoi
J Korean Acad Rehabil Med 1999;23(1):140-147.

Objective: The purposes of this study were to observe the radiographic changes of lumbar facet joints by magnetic resonance imaging (MRI) in conservatively and operatively treated groups of patients with herniated intervertebral disc, and to compare the biomechanical effects to lumbar facet joints according to the treatment methods

Method: The patients composed of 20 conservatively treated control group and 40 operatively treated group who had disc herniation at lower lumbar spine. Follow-up MRIs were performed in order to assess the radiographic changes of intervertebral disc and lumbar facet joints, such as disc degeneration, lumbar facet joint angle and tropism in either treatment groups individually.

Results: There are significant increase in lumbar facet joint angle in operatvely treated group at the level of both L4/5, right L5/S1 compared to that of conservately treated group, but the disc degeneration and facet joint tropism were not changed after treatment in both groups. There's no relationship between treatment period and each parameters.

Conclusion: The radiographic biomechanical lumbar facet joint changes on MRI seems to be related to degenerative change of lumbar facet joint in operatively treated group with a lumbar disc herniation. Therefore, careful selection of optimal operation time and criteria would be important.

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