Medical terminology for "stuck" facet joints?

Blairsara · #1 (**permalink**) 12-21-2006, 02:37 AM

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 · #2 (**permalink**) 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 · #3 (**permalink**) 12-21-2006, 05:20 PM

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 · #4 (**permalink**) 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 · #5 (**permalink**) 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)

Also Mark - I'm Blair, not Michelle

mmglobal · #6 (**permalink**) 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