Cervical facet capsular ligament yield defines the threshold for injury and persistent joint-mediated neck pain

2007 ◽  
Vol 40 (10) ◽  
pp. 2299-2306 ◽  
Author(s):  
Kyle P. Quinn ◽  
Beth A. Winkelstein
Keyword(s):  
Neck Pain ◽  
Capsular Ligament ◽  
Cervical Facet

Collagen Fiber Organization in the Cervical Facet Capsular Ligament Following Painful Facet Joint Distraction in the Rat

2007 ◽  
Author(s):  
Kathryn E. Lee ◽  
Beth A. Winkelstein
Keyword(s):  
Neck Pain ◽  
Facet Joint ◽  
Chronic Neck Pain ◽  
In Vivo Studies ◽  
Ligament Injury ◽  
Capsular Ligament ◽  
Joint Distraction ◽  
Pain Symptoms ◽  
Cervical Facet

Chronic neck pain following whiplash is a substantial problem, affecting as many as 42% of whiplash patients [1]. The cervical facet joint is a common candidate for producing neck pain because it sustains altered kinematics during whiplash, with tensile stretch of its capsular ligament exceeding that during normal motions [2,3]. Altered facet capsule mechanics have been documented for loading conditions below structural failure [4,5]; evidence of both decreased linear stiffness and minor ruptures of the capsule suggest ligament injury prior to failure. In vivo studies have also implicated subfailure capsule injury as a potential source of pain. Capsule nociceptive pain fiber activation and saturation [6], as well as sustained pain symptoms [7], can be produced for facet joint distraction below gross failure.

scholarly journals Tropism of Sub-Axial Cervical Facet Joints Is Not Related to Segmental Movement during Active Movement or Therapist-Perceived Symptomatic Locations

Symmetry ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 739
Author(s):  
Neil Tuttle ◽  
Kerrie Evans ◽  
Clarice Sperotto dos Santos Rocha
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Active Movement ◽  
Facet Joints ◽  
Segmental Mobility ◽  
Limited Mobility ◽  
Translational Movement ◽  
The Difference ◽  
Cervical Facet ◽  
The Relationship

Tropism, or asymmetry, of facet joints in the cervical spine has been found to be related to degenerative changes of the joints and discs. Clinicians often assume that differences in segmental mobility are related to tropism. The aims of this study were to determine the relationship between asymmetry of facet joints in the sub-axial cervical spine and (1) segmental mobility and (2) spinal levels perceived by therapists to have limited mobility. Eighteen participants with idiopathic neck pain had MRIs of their cervical spine in neutral and at the end of active rotation. Angular movement and translational movement of each motion segment was calculated from 3D segmentations of the vertebrae. A plane was fitted to the facet on each side. Tropism was considered to be the difference in the orientation of the facet planes and ranged from 1 to 30° with a median of 7.7°. No relationships were found between the extent of tropism and either segmental movement or locations deemed to be symptomatic. Tropism in the sub-axial cervical spine does not appear to be related to segmental mobility in rotation or to levels deemed to be symptomatic.

Transient tetraplegia after cervical facet joint injection for chronic neck pain administered without imaging guidance

2006 ◽  
Vol 108 (7) ◽  
pp. 709-711 ◽  
Author(s):  
Josef G. Heckmann ◽  
Christian Maihöfner ◽  
Stefan Lanz ◽  
Christophe Rauch ◽  
Bernhard Neundörfer
Keyword(s):  
Neck Pain ◽  
Facet Joint ◽  
Chronic Neck Pain ◽  
Joint Injection ◽  
Facet Joint Injection ◽  
Imaging Guidance ◽  
Cervical Facet ◽  
Cervical Facet Joint

scholarly journals Systematic Review of the Therapeutic Effectiveness of Cervical Facet Joint Interventions: An Update

2012 ◽  
Vol 6;15 (6;12) ◽  
pp. E839-E868 ◽  
Author(s):  
Frank J.E. Falco
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Joint Pain ◽  
Observational Studies ◽  
Facet Joint ◽  
Medial Branch ◽  
Radiofrequency Neurotomy ◽  
Facet Joint Interventions ◽  
Cervical Facet ◽  
Cervical Facet Joint

Background: The prevalence of chronic, recurrent neck pain is approximately 15% of the adult general population. Controlled studies have supported the existence of cervical facet or zygapophysial joint pain in 36% to 67% of these patients, when disc herniation, radiculitis, and discogenic are not pathognomic. However, these studies also have shown false-positive results in 27% to 63% of the patients with a single diagnostic block. There is also a paucity of literature investigating therapeutic interventions of cervical facet joint pain. Study Design: Systematic review of therapeutic cervical facet joint interventions. Objective: To determine and update the clinical utility of therapeutic cervical facet joint interventions in the management of chronic neck pain. Methods: The available literature for utility of facet joint interventions in therapeutic management of cervical facet joint pain was reviewed. The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria as utilized for interventional techniques for randomized trials and the criteria developed by the Newcastle-Ottawa Scale criteria for observational studies. The level of evidence was classified as good, fair, and limited or poor based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to June 2012, and manual searches of the bibliographies of known primary and review articles. Outcome Measures: The primary outcome measure was pain relief (short-term relief = up to 6 months and long-term > 6 months). Secondary outcome measures were improvement in functional status, psychological status, return to work, and reduction in opioid intake. Results: In this systematic review, 32 manuscripts were considered for inclusion. For final analysis, 4 randomized trials and 6 observational studies met the inclusion criteria and were included in the evidence synthesis. Based on one randomized, sham-controlled, double-blind trial and 5 observational studies, the indicated evidence for cervical radiofrequency neurotomy is fair. Based on one randomized, double-blind, active-controlled trial and one prospective evaluation, the indicated evidence for cervical medial branch blocks is fair. Based on 2 randomized controlled trials, the evidence for cervical intraarticular injections is limited. Limitations: Paucity of the overall published literature and specifically lack of literature for intraarticular cervical facet joint injections. Conclusions: The indicated evidence for cervical radiofrequency neurotomy is fair. The indicated evidence for cervical medial branch blocks is fair. The indicated evidence for cervical intraarticular injections with local anesthetic and steroids is limited. Key words: Chronic neck pain, cervical facet or zygapophysial joint pain, cervical medial branch blocks, cervical radiofrequency neurotomy, cervical intraarticular facet joint injections

scholarly journals Structural Changes in the Cervical Facet Capsular Ligament: Potential Contributions to Pain Following Subfailure Loading

2007 ◽  
Author(s):  
Kyle P. Quinn ◽  
Kathryn E. Lee ◽  
Chukwunyere C. Ahaghotu ◽  
Beth A. Winkelstein
Keyword(s):  
Structural Changes ◽  
Capsular Ligament ◽  
Cervical Facet

Microstructural Modeling of Fiber Kinematics and Biomechanics of the Human Facet Capsular Ligament During Subfailure Loading

2010 ◽  
Author(s):  
Nathan D. Crosby ◽  
Kyle P. Quinn ◽  
Beth A. Winkelstein
Keyword(s):  
Mechanical Response ◽  
Facet Joint ◽  
Chronic Neck Pain ◽  
The United States ◽  
Neck Injuries ◽  
Capsular Ligament ◽  
Microstructural Modeling ◽  
Mechanical Responses ◽  
Cervical Facet ◽  
Cervical Facet Joint

Whiplash and other traumatic neck injuries are a primary cause of chronic neck pain in the United States, with the cervical facet joint and its ligament being a common anatomical source of the pain. During these injuries, the facet capsular ligament undergoes excessive stretching that alters the subsequent mechanical function of the facet joint and can also initiate pain [1,2]. Accordingly, defining the mechanical response of the facet capsule requires understanding its microstructural response during loading. Although the macro-mechanical responses of ligaments for many types of loading and injury scenarios have been studied, the microstructural and fibrillar responses in the facet capsular ligament remain largely undefined.

In Vivo Cervical Facet Capsule Distraction: Mechanical Implications for Whiplash and Neck Pain

2004 ◽  
Author(s):  
Kathryn E. Lee ◽  
Martin B. Davis ◽  
Roanne M. Mejilla ◽  
Beth A. Winkelstein
Keyword(s):  
Neck Pain ◽  
Cervical Facet

scholarly journals Does cervical facet degeneration impact surgical outcomes and sagittal balance in patients with radiculopathy?

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zheng Wang ◽  
Zhen Liu ◽  
Zhi-Wei Wang ◽  
Wen-Yuan Ding ◽  
Da-Long Yang
Keyword(s):  
Neck Pain ◽  
Sagittal Alignment ◽  
Cervical Radiculopathy ◽  
Good Choice ◽  
Disc Height ◽  
Duration Of Symptoms ◽  
Single Segment ◽  
Functional Scores ◽  
Cervical Facet

Abstract Purpose In our present study, we aimed to investigate (1) whether cervical facet degeneration (FD) affects the clinical functional scores of patients with cervical radiculopathy after single-segment anterior cervical discectomy fusion (ACDF) and (2) whether FD affects the sagittal parameters of the cervical spine. Methods A total of 120 enrolled patients who underwent single-segment ACDF for radiculopathy with more than 2 years of follow-up were classified into two groups based on whether the preoperative mean FD was greater than or less than the mean FD grading score: mild FD group (mean score ≤ 2, n = 102) or severe FD group (mean score > 2, n = 48). Sagittal alignment changes and clinical functional scores were compared between the 2 groups. The relevant factors for FD were identified using multivariate logistic regression. Results Age, duration of symptoms, disc height and interfacet distance were independently associated with preoperative FD (age: P < 0.001; duration of symptoms: P = 0.020; disc height: P < 0.001; interfacet distance: P = 0.045). Compared with the mild FD group, the preoperative VAS (neck pain) score and NDI of the severe FD group were also higher, and the improvement of neck symptoms was better during the follow-up period. However, all clinical scores and radiographic parameters showed no significant differences during the 2-year follow-up. Additionally, no significant differences in the sagittal parameter changes were presented. Conclusion Patients with severe FD tended to experience more severe neck pain before surgery and greater improvement of neck symptoms at the follow-up visit. However, 2-year clinical efficacy and sagittal alignment after ACDF may not be markedly affected by preoperative FD severity. ACDF is considered to be a good choice for patients with radiculopathy, especially for patients with severe FD.

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