Four articular processes join with the articular processes of adjacent vertebrae to form the facet joints. The facet joints, along with the intervertebral discs, allow for motion in the spine. These joints are visible at the back (posterior) of each vertebral body. Facet joints help the spine to bend, twist, and extend in different directions. The facet joints restrict excessive movement such as hyperextension and hyperflexion (e.g., whiplash). Each vertebra has two facet joints. The superior articular facet faces upward and works like a hinge with the inferior articular facet (below). Like other joints in the body, each facet joint is surrounded by a capsule of connective tissue and produces synovial fluid to nourish and lubricate the joint. The surfaces of the joint are coated with cartilage that helps each joint to move (articulate) smoothly.
With degeneration, the synovium produces extra fluid as a way to protect the facet joints. Over time, a small amount of fluid can escape the joint capsule, but remain within the synovium, creating a facet cyst which is a sac-like protrusion.
Not all patients with facet cysts have symptoms. As the fluid builds up, it can cause spinal stenosis and pressure on the spinal nerves which may cause leg pain, numbness, tingling, or weakness (radiculopathy).
Diagnosis is made from your symptoms, history, physical exam, and MRI imaging. Treatment is dependent on the severity of symptoms, but often initially includes non-operative treatment such as formal physical therapy, anti-inflammatory medications, and activity modifications.
If your condition does not improve with conservative treatment, Dr. Stieber can suggest surgical solutions to relieve pain and increase level of function. If surgery is required, Dr. Stieber offers expertise and a variety of treatment options utilizing minimally invasive techniques.