Facet Joint Degeneration Research Articles

Comparison of disc and facet joint degeneration and quality of life in stopping fusion at L3 versus L4 in AIS: An MRI study with mean 17 (15-21) years follow up

Comparison of disc and facet joint degeneration and quality of life in stopping fusion at L3 versus L4 in AIS: An MRI study with mean 17 (15-21) years follow up

Dimple of Venus Is Associated with the Increased Pelvic Incidence Angle and More Sagittally Oriented Facet Joint

Objectives: The present study aims to investigate whether the dimple of Venus affects the anatomy of spinopelvic junction. Subjects and Methods: Inclusion criteria were having a lumbar MRI examination in the last 1 year, being older than 18 years of age and being able to radiologically evaluate the whole vertebral colon and pelvic girdle. Exclusion criteria were having congenital diseases of the pelvic girdle/hip/vertebral column and history of fracture or previous surgery in the same anatomic regions. The patients’ demographic data and low back pain were noted. At radiological examination, the pelvic incidence angle was measured by lateral lumbar X-ray. The facet joint angle, tropism, facet joint degeneration, intervertebral disc degeneration, and intervertebral disc herniation at the level of L5-S1 were examined on lumbar MRIs. Results: We included 134 male and 236 female patients with a mean age of 47.86 ± 14.50 years and 48.49 ± 13.49 years, respectively. We found that the patients with the dimple of Venus had higher pelvic incidence angle (p < 0.001) and more sagittally oriented facet joint (right facet joint p = 0.017, left facet joint p = 0.001) compared to those without the dimple of Venus. There was no statistically significant relationship between low back pain and the presence of the dimple of Venus. Conclusions: The dimple of Venus affects the anatomy of the spinopelvic junction and is associated with an increased pelvic incidence angle and a more sagittally oriented facet joint angle.

Revision surgery after previous spinal decompression and fusion for lumbar spinal stenosis

To evaluate the incidence and indications for revision surgery after previous spinal decompression and fusion for lumbar spinal stenosis. A retrospective single-center study enrolled 1233 patients with lumbar spine stenosis who underwent spinal decompression and fusion surgery between 2014 and 2018. The number and causes of readmission were evaluated. There were 164 readmissions. Revision surgery at the same level was performed in 63 patients (38.4%), at the higher level - 72 (43.9%), at the lower level - in 29 (17.7%) patients. The most common indication for readmission was spondyloarthrosis with facet joint syndrome (94 (57.3%) patients). The second common complication was pseudoarthrosis (26 (15.9%) patients). These ones comprised 2.1% of all patients with lumbar spine stenosis. The most common indication for readmission was adjacent segment degeneration. The most severe complications requiring complex and even multiple stage revision surgery were pseudoarthrosis and postoperative spondylodiscitis. Causes of readmission are significantly changing at different periods after surgery.

A Pragmatic Randomized Prospective Trial of Cooled Radiofrequency Neurotomy of the Medial Branch Nerves Versus Facet Joint Injection of Corticosteroid for the Treatment of Lumbar Facet Syndrome: 12 Month Results

A Pragmatic Randomized Prospective Trial of Cooled Radiofrequency Neurotomy of the Medial Branch Nerves Versus Facet Joint Injection of Corticosteroid for the Treatment of Lumbar Facet Syndrome: 12 Month Results

Intervertebral vacuum phenomenon - prevalence and severity CT-scan analysis in patients older than 50 years: a retrospective cohort study.

Chronic low back pain secondary to degenerative changes in the spine is a common cause of disability, and disc degeneration is one of the most frequent imaging findings. Intervertebral vacuum phenomenon (IVP) is usually observed in advanced degeneration. Recently, this phenomenon has gained interest due to a relatively new surgical technique called percutaneous discoplasty, aimed at treating low back pain secondary to degenerative disc disease in elderly patients. To analyze the prevalence and related factors of the vacuum phenomenon in adult patients. A retrospective cohort study was performed of patients who underwent abdominal computed tomography (CT) for non-spine-related reasons. Age, body mass index, smoking, and CT-based characteristics as presence of IVP, subchondral sclerosis, and facet joint degeneration at the lumbar spine from L1 to the sacrum were included in order to determine the prevalence of the vacuum phenomenon in this population and establish a relationship between this condition and patient demographics and other signs of spine degeneration, such as sclerosis and facet joint disease. A total of 238 patients were included in the study (114 men, 124 women; mean age = 75.6 ± 12.3 years. In total, 91 (38%) patients had at least one level of IVP; 59 (25%) patients exhibited subchondral sclerosis, and 235 (98%) facet joint degeneration. Among risk factors, age, smoking, and subchondral sclerosis were significantly associated with the presence of vacuum. IVP was present in 38% of participants. Risk factors associated with vacuum were age, smoking, and subchondral sclerosis.

Common incidental findings on sacroiliac joint MRI: Added value of MRI-based synthetic CT

PurposeTo determine the prevalence of incidental findings on sacroiliac joint MRI and to determine the added value of MRI-based synthetic CT in the detection and evaluation of these incidental findings. MethodIn this retrospective study 210 patients clinically suspected of spondyloarthritis who underwent MRI of the sacroiliac joint with synthetic CT sequence were included. The images were reviewed by two radiologists in consensus for the prevalence of sacroiliitis, incidental findings, and the ability of synthetic CT and the conventional MRI to detect and diagnose these findings. ResultsIn 44.7% of patients sacroiliitis was present. In 89.0% of patients MRI showed at least one incidental finding other than sacroiliitis. Degeneration of the sacroiliac joint was the most prevalent finding (140 patients, 66.6%). The most frequent incidental findings outside the sacroiliac joint were facet joint degeneration (29.0%), disc degeneration (25.2%), enostosis (19.5%) and lumbosacral transitional vertebrae (14.3%). A total of 788 lesions was recorded and synthetic CT was found to be problem solving or necessary for diagnosis in 543 (68.9%) of these lesions. 42.1% of lesions were not visible on conventional MRI (T1 TSE and STIR), most often degenerative osteophytes in the sacroiliac joint or lower lumbar spine. ConclusionIncidental findings are seen more frequently on sacroiliac joint MRI than sacroiliitis, which is relevant as some will have clinical significance or require treatment. Nearly half of these incidental lesions were only visible on synthetic CT, which additionally has been shown to be problem solving for diagnosis in many other cases.

Impact of dyslipidemia on the severity of symptomatic lumbar spine degeneration: A retrospective clinical study.

Lumbar intervertebral disc degeneration (IVDD) is an important cause of low back pain or sciatica, and metabolic factors play an important role. However, little is known about the relationship of dyslipidemia to the risk of intervertebral disc degeneration (IVDD). This study aimed to assess the impact of serum lipid levels on the severity of lumbar disc degeneration and to investigate its association with endplate inflammation. We conducted a case retrospective study in which a total of 302 hospitalized Chinese patients were recruited, of whom 188 (112 males and 76 females; mean age: 51.66 years) were without underlying disease, while the remaining 114 patients (51 males and 63 females; mean age: 62.75 years) had underlying diseases. We examined fasting serum lipid levels for total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Magnetic resonance imaging (MRI) was used to determine endplate inflammation. Pfirrmann grading and Weishaupt grading were used to evaluate the severity of intervertebral disc degeneration and facet joint degeneration, respectively. There was no difference in age, gender, and general BMI between the two groups (P > 0.05), but there were significantly high levels in TC, LDL-C, and LDL-C/HDL-C (P = 0.04, P = 0.013, P = 0.01, respectively). TG and HDL-C showed no significant difference (P = 0.064, P = 0.336, respectively). The multivariate logistic regression model showed that age was a risk factor for the occurrence of endplate inflammation. In the group without underlying diseases, age, but not other indicators, was a risk factor for the occurrence of endplate inflammation (P < 0.01), In the group with underlying diseases, none of the patient indicators was directly related to the occurrence of endplate inflammation (P > 0.05). A nonlinear machine learning model was used to measure the contribution of each factor to the disease outcome and to analyze the effect between the top three contributing factors and the outcome variables. In patients without underlying diseases, the top three factors contributing to the severity grading of intervertebral disc degeneration were age (32.9%), high-density lipoproteins (20.7%), and triglycerides (11.8%). For the severity grading of facet joint degeneration, the top three contributing factors were age (27.7%), high-density lipoproteins (19.4%), and triglycerides (14.6%). For patients with underlying diseases, the top three factors contributing to intervertebral disc degeneration were age (25.4%), BMI (15.3%), and low-density lipoprotein/high-density lipoprotein ratio (13.9%). In terms of degree classification for facet joint degeneration, the top three contributing factors were age (17.5%), BMI (17.2%), and total cholesterol (16.7%). This study shows that age, high-density lipoprotein, and triglycerides affect the degree of degeneration in patients with symptomatic lumbar degeneration without underlying diseases. Age and BMI are two major factors affecting the severity of degeneration in patients with underlying diseases, and dyslipidemia is a secondary factor. However, there is no clear association between dyslipidemia and the occurrence of endplate inflammation in either group.

Interventional Minimally Invasive Treatments for Chronic Low Back Pain Caused by Lumbar Facet Joint Syndrome: A Systematic Review.

Systematic review. To investigate the efficacy of nonsurgical interventional treatments for chronic low back pain (LBP) caused by facet joint syndrome (FJS). A systematic review of the literature was conducted to identify studies that compared interventional treatments for LBP due to FJS among them, with usual care or sham procedures. Studies were evaluated for pain, physical function, disability, quality of life and employment status. The RoB-2 and MINORS tools were utilized to assess the risk of bias in included studies. Eighteen studies published between January 2000 and December 2021 were included (1496 patients, mean age: 54.31 years old). Intraarticular (IA) facet joint (FJ) injection of hyaluronic acid (HA) did not show significant difference compared to IA corticosteroids (CCS) in terms of pain and satisfaction. FJ denervation using radiofrequency (RF) displayed slightly superior or similar outcomes compared to IA CCS, physical therapy, or sham procedure. IA CCS showed better outcomes when combined with oral diclofenac compared to IA CCS or oral diclofenac alone but was not superior to IA local anesthetic and Sarapin. IA platelet-rich plasma (PRP) led to an improvement of pain, disability and satisfaction in the long term compared to IA CCS. FJS is a common cause of LBP that can be managed with several different strategies, including nonsurgical minimally invasive approaches such as IA HA, CCS, PRP and FJ denervation. However, available evidence showed mixed results, with overall little short-term or no benefits on pain, disability, and other investigated outcomes.

Modern approaches to modeling in vivo degenerative spine diseases

Every year, more and more people suffer from illnesses and disabilities that occur due to lumbar pain. Many studies, someof that use in-vivo models, are conducted to decrease the socioeconomic impact of the consequences of degenerative spinediseases. Objective. To evaluate the advantages and disadvantages of different in vivo models that are used to study the mechanisms of development of degenerative disturbances in spinal motion segments and test prospective methods of treating them. Methods. A search was conducted in the PubMed, Google Scholar, and Base scientific databases with the following key words: Spinal Diseases, Spine Disorder, Intervertebral Disc Degeneration (Repair), Facet Joint Degeneration (Repair), Animal Model, Facet (Zygapophyseal) Joint Osteoarthritis, Canine (dog), Swine (Pig), Ovine (sheep), Rabbit, Rat, Mice. The depth of the search was 10 years. Results. Rodents, pigs, goats, dogs, sheep, and primates are used to study mechanisms of development of degenerative disturbances in spinal motion segments and to test different approaches. Studies on larger animals are conducted due to their similarities in size, anatomy, biomechanics, and histological structure of vertebrae and intervertebral discs to humans. Models using dogs and alpacas are specifically of interest because of the natural age-related degradation of their intervertebral discs. However, experiments using large animals are restricted by high costs and bioethics regulations. The use of rabbits, rats, and mice in experiments is promising. For these animals, degenerative disturbances in the spine are modeled by creating traumatic injuries (disturbing the integrity of facet joints, endplates, annulus fibrosus, and nucleus pulposus, nucleotomy, and discectomy) or injection of chemical agents. Conclusions. The advantages of using of rodents instead of large animals to model the mechanisms of development of degenerative spine diseases and to test treatment methods include the relative ease of use and reproducibility of experiments, and economic and ethical viability. However, models should be chosen carefully and according to with the aims of the study.

Correlation between posterior paraspinal muscle atrophy and lumbar intervertebral disc degeneration in patients with chronic low back pain.

Although enormous studies have been devoted to solving the problem of intervertebral disc degeneration/herniation, little attention is paid to the effect of paraspinal muscles on it. We aimed to investigate the correlation between paraspinal muscle atrophy and lumbar disc degeneration to recognize paraspinal muscle atrophy and its importance to the spine. A total of 107 patients were enrolled in the study (65 females, 42 males; age 50.87 ± 15.391years old). Cross-sectional area, functional cross-sectional area, and fatty infiltration of the posterior paraspinal muscles were measured at the level of L4/5, and the degree of facet joint degeneration was evaluated at the levels of L3/4, L4/5, and L5/S1 by MRI. After controlling the confounding factors by multiple linear regression, the correlations among paraspinal muscle atrophy, disc degeneration, and facet joint degeneration were analyzed. Meanwhile, Pearson/Spearson rank analysis was used to analyze the correlation between clinical symptoms (VAS and ODI) and paraspinal muscle atrophy. There was a strong correlation between paraspinal muscle atrophy and disc degeneration after controlling the confounding factors (p < 0.05, R > 0.5). There was a weak correlation between paraspinal muscle atrophy and facet joint degeneration (p < 0.05, R < 0.5). There was a significant correlation between facet joint degeneration and intervertebral disc degeneration (p < 0.05, R > 0.7). The fatty infiltration of paraspinal muscle was weakly correlated with ODI (p < 0.05, R < 0.3), but VAS was not. The degree of paraspinal muscle atrophy increased with lumbar disc degeneration and facet joint degeneration and fatty infiltration of multifidus was more susceptible to weight.

Facet Joint Syndrome: Pathophysiology, Diagnosis, and Treatment.

Facet joint osteoarthritis (OA) is the most frequent form of facet joint syndrome. Medical history, referred pain patterns, physical examination, and diagnostic imaging studies (standard radiographs, magnetic resonance imaging, computed tomography and single-photon emission computed tomography) may suggest but not confirm lumbar facet joint (LFJ) syndrome as a source of low back pain (LBP). However, the diagnosis and treatment of facet joint syndrome is still controversial and needs further study. It is widely acknowledged that block with local anesthetic is perhaps the most effective method to establish a diagnosis of pain from LFJ. Particularly, there are different rates of success among different populations selected for diagnostic block with various positive criteria. Currently, in addition to conservative treatments for pain such as painkillers, functional exercises, and massage, there are many other methods, including block, denervation of the nerves that innervate the joints by radiofrequency, freezing or endoscopy, and injections. Due to the limited duration of pain relief from neurolysis of medial branch, many scholars have recently turned their targets to dorsal roots and LFJ capsules. Therefore, we reviewed the latest research progress of facet joint syndrome from diagnosis to treatment.

Lumbar Facet Joint Effusion on Magnetic Resonance Imaging: Do Different Joint Effusion Images Have Different Clinical Values?

The objective of the study was to explore the significance of the distribution of lumbar facet joint effusion (unilateral or bilateral) and the amount of joint effusion in the process of lumbar degeneration. A total of 142 patients with L4-5 lumbar facet joint effusion in our hospital from December 2020 to December 2021 were analyzed retrospectively, including 69 cases of unilateral facet joint effusion and 73 cases of bilateral facet joint effusion. The correlation between joint effusion width, effusion area and lumbar stability, facet joint degeneration grade, lumbar intervertebral disc degeneration index, and lumbosacral angle (LSA) was analyzed. To study the significance of the distribution of joint effusion, the patients were divided into unilateral and bilateral effusion groups. The size of the LSA in the bilateral effusion group was significantly larger than that in the unilateral effusion group (t=3.6634, P<0.05). There was a significantdifference in the proportion of stability between both groups (P<0.05). The width of the joint effusion was positively correlated with lumbar stability and the LSA. When the width of the joint effusion was 2mm, the probability of lumbar instability was 58.1%. The area of joint effusion was positively correlated with lumbar stability and the LSA. When the area of effusion was 0.2cm2, the probability of lumbar instability was 58.9%. A bilateral effusion signal is more likely to indicate lumbar instability than a unilateral effusion signal. The distribution width and area of effusion were positively correlated with lumbar stability and LSA.

Early Readmission and Reoperation After Percutaneous Transforaminal Endoscopic Decompression for Degenerative Lumbar Spinal Stenosis: Incidence and Risk Factors.

To identify the incidence rates and risk factors for early readmission and reoperation after percutaneous transforaminal endoscopic decompression (PTED) for degenerative lumbar spinal stenosis (DLSS). A total of 1011 DLSS patients who underwent PTED were retrospectively evaluated. Of them, 58 were readmitted, and 31 underwent reoperation. The patients were matched with 174 control patients to perform case-control analyses. The clinical and preoperative imaging data of each patient were recorded. Univariate analyses were performed using independent sample t-tests and Fisher's exact tests. Furthermore, the risk factors for early readmission and reoperation were analyzed using multivariate logistic regression analyses. The incidence rates of readmission and reoperation within 90 days after PTED were 5.7% and 3.1%, respectively. Age (odds ratio [OR]=1.054, p=0.001), BMI (OR=1.104, p=0.041), a history of lumbar surgery (OR=3.260, p=0.014), and the number of levels with radiological lumbar foraminal stenosis (LFS, OR=2.533, p<0.001) were independent risk factors for early readmission. The number of levels with radiological LFS (OR=5.049, p<0.001), the grade of surgical-level facet joint degeneration (OR=2.010, p=0.023), and a history of lumbar surgery (OR=10.091, p<0.001) were independent risk factors for early reoperation. This study confirmed that aging, a higher BMI, a history of lumbar surgery, and more levels with radiological LFS were associated with a higher risk of early readmission. More levels with radiological LFS, a higher grade of surgical-level facet joint degeneration, and a history of lumbar surgery were predictors of early reoperation. These results are helpful in patient counseling and perioperative evaluation of PTED.

Changes in paraspinal muscles and facet joints after percutaneous endoscopic transforaminal lumbar interbody fusion for the treatment of lumbar spinal stenosis: A 3-year follow-up.

This study investigates the changes in the paraspinal muscles of lumbar spinal stenosis patients after percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF). Thirty-three patients from Beijing Chaoyang Hospital who had L4/5 segment lumbar spinal stenosis between January, 2017 and January, 2019were included in this study. Patient-reported outcomes including the visual analog scale scores for back pain and leg pain (VAS-BP and VAS-LP, respectively) and the Oswestry disability index (ODI) scores at pre-operation and 1-week, 3-month, 12-month, and (at least) 3-year follow-up (the final follow-up) were evaluated. Computed tomography (CT) was performed at the 12-month follow-up, 24-month follow-up, and the final follow-up after surgery. Multifidus (MF) muscle functional cross-sectional area (FCSA) and fat infiltration (FI) were evaluated, and the degree of adjacent facet joint degeneration was evaluated using Pathria scores. All patients underwent at least a 3-year follow-up period. The VAS-BP, VAS-LP, and ODI were significantly lower at 1-week, 3-month, 12-month, and 3-year follow-up than at pre-operation (P < 0.05). At the 3-year follow-up, no differences were found in FCSA and FI for any patient's MF muscle at the lower third of the vertebral body (L3) above the operation level (P > 0.05), and there was no statistical difference in the central plane of the L3/4 and L5/S1 vertebral facet joints at pre-operation, 12-month, 24-month, and 3-month follow-up (P > 0.05). PE-TLIF can provide satisfactory clinical outcomes for patients with lumbar spinal stenosis. Furthermore, the technique may also reduce the injury on the paravertebral muscles, especially the MF muscle, as well as on adjacent facet joints.

Massive Obstruction of the Spinal Canal and Progressive Cervical Myelopathy due to Osseous Hypertrophy of a Facet Joint: A Case Report

Introduction: Cervical spondylotic myelopathy is one of the most common causes of cervical spinal cord dysfunction. Case Report: A 65-year-old patient was admitted with slowly-progressing myelopathic symptoms. Imaging studies indicated a massive lesion, which was thought to be a primary bone tumor. Resection at Segment C4 was performed, and histopathology showed hypertrophic facet joint. Discussion: Age-related degenerative changes and adaptation mechanisms result in hypertrophy of the joint and synovial cyst formation. In our case, it was enormous, and could be easily mistaken for a tumorous process. Conclusion: Such extensive hypertrophic changes are rarely addressed in the literature and should be considered as differential diagnosis.

Magnetic Resonance Imaging of Lumbar Spine in Lower Backache: A Comparative Study on Gender Basis

Objective: To compare the clinical features of lower backache with Magnetic Resonance Imaging (MRI) findings on gender basis. Study design &amp; Setting: A cross-sectional descriptive study was carried out among male &amp; female patients with a backache at Sir Syed Hospital, Karachi. This study conducted from 1st Jan 2020 to 1st June 2020. We studied 90 patients by using the non-probability convenient sampling technique. Methodology: Lower backache is a common problem that creates disability. MRI lumbar spine without contrast were reviewed with clinical complaints. Performa was used after the ethical approval from Institutional Research and Ethical committee. Components focused during the study in MRI findings at different spinal levels were disc bulging, neural foraminal compromise, nerve root compression, ligamentum flavum and facet joint hypertrophy. Results: The results showed that the mean age of 90 patients was 44.64 years. On MRI imaging 46(86.8%) males and 26(70.3%) females had disc desiccation but multi-level disc osteophyte complexes were demonstrated more in females 11(29.7%). Diffuse disc bulge is more in males at L4-5 and L5-S1 level 49(92.5%) than in females 34(91.9%) at L4-5 and 33(89.2%) at L5-S1 level with mild to moderate spinal canal stenosis. The narrowing of Neural foramen is almost similar at L4-5 level in both gender but more at L5-S1 in females 35(94.6%) as compared to males 49(92.5%) with nerve root compression. Overall male patients tended to have slightly more disc degenerative changes than females. Conclusion: Lower Lumbar disc disease is a common problem showing significant disc space narrowing and bulges slightly more in our male population than females.

Low Back Pain and Lumbar Degeneration in Japanese Professional Baseball Players.

Background:Baseball is one of the most popular sports in Asia. It is known that baseball can easily lead to back pain. However, there has been no survey of low back pain (LBP) and lumbar disc degeneration in Japanese professional baseball players to date.Purpose:To investigate the cause of LBP and lumbar degeneration in professional Japanese baseball players.Study Design:Cross-sectional study; Level of evidence, 3.Methods:We retrospectively reviewed the medical records of Japanese professional baseball players with LBP who visited our hospital. Data were collected from July 2018 to April 2021. We also investigated whether the results differed between players in their 20s and 30s or between pitchers and fielders. Data analysis was performed using the chi-square test.Results:We surveyed 32 professional baseball players. The most frequent causes of LBP among players in their 20s (n = 21) were lumbar disc herniation (LDH; 57%) and spondylolysis (24%). Of the players with spondylolysis, 50% had adult-onset spondylolysis. Players in their 30s (n = 11) most commonly had discogenic pain (55%) as well as LDH and facet joint arthritis (each 18%). The incidence of lumbar intervertebral disc degeneration was significantly higher in players in their 30s (91%) than those in their 20s (14%), as was the incidence of Schmorl nodes and Modic type 1 changes. There was no significant difference in the cause of LBP or the incidence of lumbar intervertebral disc degeneration between pitchers and fielders (P = .59).Conclusion:Among professional baseball players in their 20s, lumbar degeneration was less common, and they most frequently developed diseases less related to degeneration, such as LDH. However, among players in their 30s, lumbar degeneration was more advanced, and degenerative diseases such as discogenic pain occurred more frequently. Research on training methods could lead to the prevention of LBP. Our data may be applicable to other professional athletes and will contribute to diagnosis and treatment.

Treatment of spondyloarthritis (facet syndrome) by puncture techniques

Objective. The aim of the study was to determine effectiveness of radiofrequency denervation of facet joints in combination with periarticular administration of local anaesthetics and steroids for elimination of pain in patients with low lumbar pain and predominantly spondyloarthritis. Material and methods. 78 patients with lower lumbar pain syndrome and arcuate joints arthrosis as a leading clinical manifestation underwent radiofrequency denervation of facet joints and periarticular administration of local anaesthetic and steroid drug (main group). The control group involved 136 patients with lumbar pain and dominating spondylarthritis treated only by radiofrequency denervation of facet joints. Results. Both in the early and late periods after treatment, reliable results were obtained in treatment of chronic lower lumbar pain caused mainly by arcuate joints damage both in the main and control groups. However, there was a significant difference between the main group and the control group in the early period (in three months after treatment), in favour of the main group. In the late period (in 1 year after treatment) a reliable treatment result was obtained both in the main and control groups, but there was no difference in the treatment results between these groups. Conclusions. Periarticular administration of local anaesthetics and steroids is effective in the short term, and radiofrequency denervation of facet joints is effective in both the short and longer term.

Reply Letter to "Cervical Facet Joint Degeneration".

Reply Letter to "Cervical Facet Joint Degeneration".

Cervical Facet Joint Degeneration.

Cervical Facet Joint Degeneration.