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-   -   Medical terminology for "stuck" facet joints? (http://www.ispine.org/forum/ispine/228-medical-terminology-stuck-facet-joints.html)

Blairsara 12-21-2006 02:37 AM

Medical terminology for "stuck" facet joints?
 
Does anyone know the medical terminology for "stuck overextended" facet joints?? I'm thinking that it's subluxation but I'm not sure. Anyone? Thanks.

mmglobal 12-21-2006 04:33 PM

Michelle,

I believe that I subluxated my facets once. 3 weeks short of 2 years post-op, I reached over my desk to pick up something that dropped off the other side. (I'm over 6'3".) When I stood up I got a shot of severe low back pain that reminded me of my pre-op pain... very intense, momentary pain-level 10. While the pain subsided from level 10, it remained at 6-8 for a few days. This happened on a Saturday and the pain remained. 8am Monday morning, I was in my doctors office saying 'fit me in'. I got a set of xrays to insure that everything looked OK. Since I was at the 2-year mark, I also had them do flexion/extension xrays to show motion.

Everything looked OK and by Wednesday I was kicking myself for panicking because the pain episode had blown over. Based on my experience it's hard to imaging your facets staying subluxated without being at a pain-level of 9 or 10. In my case, it certainly caused some inflammation and lingering pain that lasted about 4-5 days.

I hope this helps,

Mark

PS. As a side note, the flexion/extension xrays done on Monday morning when I was still in pain showed almost zero movement at L5-S1 and little movement at L4-5. 3-weeks later I kept my 2-year follow-up visit and insisted on another set of flexion/extension xrays. The second set, taken when I was not in pain showed very nice movement at both levels.

Poncho 12-21-2006 05:20 PM

Med Term
 
Hummm - stuck facets....I have never heard of that in my spiney journey or while in healthcare. However, it sounds painful.

Subluxation - it looks like it could fit the definition.

Another term could be spinal hyperextension injury - perhaps?

TTYL,
Poncho

mmglobal 12-21-2006 07:46 PM

From Steadman's medical dictionary:

luxation = dislocation

subluxation = "an incomplete luxation or dislocation; though a relationship is altered, contact between joint surfaces remains."

In my case it was easy to imagine moving the sliding surfaces of the facet far enough so that they caught on each other, putting intense pressure on a very small surface. Hold your hands together in front of your body like you are praying and press them together. They are like the sliding surfaces of the facets. Then move them so they are incongruent... the little finger on one hand moves towards, then past the thumb on the other... when you go too far, the joint surfaces are dislocated.... putting them back together will put intense pressure on a very small surface.

Blairsara 12-21-2006 10:11 PM

Thanks guys. Ya basically my right facet joints have been stuck in that position since about the end of September. And you are absolutely right about the pain being terrible - it sucks!
I'm seeing my doctor in the beginning of January to talk about 1) my original facet pain - the overrextension and then 2) why/how my right facet joints are stuck in that position and 3) why wont they go back!!!
There's not a lot of information out there about this problem in connection to ADR.
"I always like the fact that I was unique, but when it comes to this .... ^#$&*@ that!!!"

(That's my new quote about my back - I think it's funny) :p

Also Mark - I'm Blair, not Michelle :)

mmglobal 12-22-2006 02:39 PM

Blair,

It's hard for me to imagine a facet stuck in a subluxated position. If it were subluxated, I would expect the pain to be more than you could tolerate and that they would be resolving the subluxation with external manipulation.... possibly even manipulation under anesthesia. If it were to remain subluxated or continue to find it's way into a subluxated position, then I would suspect that there was a substantial instability and structural issue... possibly a fracture, blown ligament, blown facet capsule, or ??? My guess is that this would ultimately result in treatment that is a step further than ADR, like posterior stabilization or fusion.

I do know people who have required stabilization after ADR. Each case is quite unique... some have done well and some have not. In the cases where the indications were clear, they have done well.

Mark

Blairsara 12-23-2006 12:05 AM

Ya i know that this is something that isnt common. I'm going in to see my doctor in the beginning of January but the pictures from when they did the rhizotomy showed that my facet joint is stuck in that overextended position and basically I have been in terrible pain since late September/early October. I had direct orders to see my doctor asap from my doctor who did the rhizo. He said that it could go back by itself but that I needed to see my doctor.
I'm basically on pain killers all the time b/c of it.
Whatever the medical terminology is for it it sucks! ahha oh well. hopefully one day I wont be in a constant state of pain.

Jim M2 12-24-2006 03:15 PM

For the first two years after ADR I was always complaining on other forums about popping of my lumbar. I would be miserable for days or weeks, then as a result of some motion I could detect a pop or feel something suddently move at the surgery level. Right away I could feel relief starting to come on, like a good painkiller kicking in. I never got painfree but the pain came down from the higher levels. Just the opposite could happen too. There could be a pop and I could suddenly feel pain start to grow. I wonder if stuck facets are the same or related phenomena?

Blairsara 12-29-2006 04:42 AM

so i think that dislocation was the wrong term for what's going on with my facet joints but rather malalignment? I'm going in on the 3rd so I guess I can find out the actual medical terminology from Dr. Regan.

Blairsara 12-29-2006 04:44 AM

Jim
usually when I feel the pop that you were talking about it would make things worse but I know exactly what you're talking about. How are you feeling by the way?


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