Malformation of a cervical facet joint with inclusion of an arthrolith

1994 ◽  
Vol 80 (4) ◽  
pp. 745-747 ◽  
Author(s):  
Franz Jürgen Prestar ◽  
Peter C. Potthoff

✓ The authors present the case of a 49-year-old man with an isolated malformation of the left cervical facet joint at C5–6, with secondary spondylarthrotic hypertrophy of the joint leading to involvement of the C-6 nerve root. The etiology of this cervical joint malformation is discussed.

1974 ◽  
Vol 41 (3) ◽  
pp. 372-376 ◽  
Author(s):  
Chun C. Kao ◽  
Stefan S. Winkler ◽  
J. H. Turner

✓The authors report a case in which a true synovial cyst was found attached to a cervical facet joint. The differential diagnosis involving herniated cervical disc as well as other types of extradural cyst is discussed. The anatomically oriented term “juxta-facet cyst” is proposed to include both ganglion and synovial cysts seen in this area.


2001 ◽  
Vol 95 (1) ◽  
pp. 135-138 ◽  
Author(s):  
Anthony J. Muffoletto ◽  
Remi Nader ◽  
Richard M. Westmark ◽  
Haring J. W. Nauta ◽  
Kim J. Garges ◽  
...  

✓ Two cases of hematogenous, pyogenic, subaxial cervical facet joint infection are reported, and the literature is reviewed. Infection of the cervical facet joint is a rarely diagnosed condition; only one case has been reported in the literature. Lumbar facet joint infections are also rare but more commonly reported. Approximately one fourth of facet joint infections in the lumbar spine are complicated by epidural abscess formation, which can lead to a neurological deficit. Because of the paucity of reports on cervical facet joint infections, the clinical characteristics of this entity are not well known. Both patients presented with an acute onset of unilateral neck pain that radiated into the ipsilateral shoulder. Frank radicular pain was initially absent. Unilateral upper-extremity motor weakness that was attributed to associated epidural abscess or granulation tissue formation was also demonstrated in both patients. Leukocyte count and erythrocyte sedimentation rate were elevated in both cases. Magnetic resonance imaging was necessary to obtain an accurate diagnosis. Staphylococcus aureus was identified as the offending pathogen in both cases. Decompressive surgery and antibiotic therapy were required to cure the condition. One patient recovered completely and the other sustained a permanent motor deficit. Hematogenous cervical facet joint infection is a rare clinical entity that has many characteristics in common with the more-common lumbar homolog. All three reported cases, however, have been complicated by epidural abscess or granulation tissue formation that has led to a neurological deficit. This finding suggests that a facet joint infection in the cervical spine may have a less benign clinical course than that in the lumbar spine.


2005 ◽  
Vol 3 (6) ◽  
pp. 471-476 ◽  
Author(s):  
Brian D. Stemper ◽  
Narayan Yoganandan ◽  
Thomas A. Gennarelli ◽  
Frank A. Pintar

Object. Although facet joints have been implicated in the whiplash injury mechanism, no investigators have determined the degree to which joint motions in whiplash are nonphysiological. The purpose of this investigation was to quantify the correlation between facet joint and segmental motions under physiological and whiplash loading. Methods. Human cadaveric cervical spine specimens were exercise tested under physiological extension loading, and intact human head-neck complexes were exercise tested under whiplash loading to correlate the localized component motions of the C4–5 facet joint with segmental extension. Facet joint shear and distraction kinematics demonstrated a linear correlation with segmental extension under both loading modes. Facet joints responded differently to whiplash and physiological loading, with significantly increased kinematics for the same-segmental angulation. The limitations of this study include removal of superficial musculature and the limited sample size for physiological testing. Conclusions. The presence of increased facet joint motions indicated that synovial joint soft-tissue components (that is, synovial membrane and capsular ligament) sustain increased distortion that may subject these tissues to a greater likelihood of injury. This finding is supported by clinical investigations in which lower cervical facet joint injury resulted in similar pain patterns due to the most commonly reported whiplash symptoms.


2003 ◽  
Vol 98 (3) ◽  
pp. 264-270 ◽  
Author(s):  
Youn-Kwan Park ◽  
Joo Han Kim ◽  
Hung Seob Chung ◽  
Jung Keun Suh

Object. When performing surgery, the extraforaminal window is very narrow at the L5—S1 level. The authors describe a microsurgical method for decompression of the L-5 nerve root trapped between a marginal osteophyte of the vertebral body and the transverse process. The procedure was performed in 16 patients with extraforaminal stenosis. Methods. The cranial part of the L5—S1 facet joint and the caudal portion of the pedicle and transverse process of L-5 were removed via a midline skin incision and partial resection of the pars interarticularis; a high-speed drill was used as was a surgical microscope. The affected nerve root was decompressed and mobilized cranially. Postoperatively all patients reported excellent relief of their sciatic pain, and there were no technique-associated complications. There was no recurrence during the follow-up period, that ranged from 14 to 70 months. Conclusions. The authors recommend this technique for the effective decompression of symptomatic extraforaminal L5—S1 stenosis. The need for a dangerous and tedious removal of the vertebral osteophyte together with spinal fusion is avoided.


2010 ◽  
Vol 50 (4) ◽  
pp. 657-663 ◽  
Author(s):  
Linqiu Zhou ◽  
Zarinah Hud-Shakoor ◽  
Christopher Hennessey ◽  
Avi Ashkenazi

1990 ◽  
Vol 72 (3) ◽  
pp. 378-382 ◽  
Author(s):  
Joseph C. Maroon ◽  
Thomas A. Kopitnik ◽  
Larry A. Schulhof ◽  
Adnan Abla ◽  
James E. Wilberger

✓ Lumbar-disc herniations that occur beneath or far lateral to the intervertebral facet joint are increasingly recognized as a cause of spinal nerve root compression syndromes at the upper lumbar levels. Failure to diagnose and precisely localize these herniations can lead to unsuccessful surgical exploration or exploration of the incorrect interspace. If these herniations are diagnosed, they often cannot be adequately exposed through the typical midline hemilaminectomy approach. Many authors have advocated a partial or complete unilateral facetectomy to expose these herniations, which can lead to vertebral instability or contribute to continued postoperative back pain. The authors present a series of 25 patients who were diagnosed as having far lateral lumbar disc herniations and underwent paramedian microsurgical lumbar-disc excision. Twelve of these were at the L4–5 level, six at the L5–S1 level, and seven at the L3–4 level. In these cases, myelography is uniformly normal and high-quality magnetic resonance images may not be helpful. High-resolution computerized tomography (CT) appears to be the best study, but even this may be negative unless enhanced by performing CT-discography. Discography with enhanced CT is ideally suited to precisely diagnose and localize these far-lateral herniations. The paramedian muscle splitting microsurgical approach was found to be the most direct and favorable anatomical route to herniations lateral to the neural foramen. With this approach, there is no facet destruction and postoperative pain is minimal. Patients were typically discharged on the 3rd or 4th postoperative day. The clinical and radiographic characteristics of far-lateral lumbar-disc herniations are reviewed and the paramedian microsurgical approach is discussed.


1973 ◽  
Vol 39 (4) ◽  
pp. 528-532 ◽  
Author(s):  
James E. McLennan ◽  
William T. McLaughlin ◽  
Stanley A. Skillicorn

✓ A patient is described who developed an acute, occult, lumbosacral nerve root meningocele following a partial traumatic avulsion of the L-4 and L-5 nerve roots accompanied by fracture of the pelvis and fibula. Almost total functional recovery ensued. The differences between acute and chronic nerve root meningoceles are discussed, as well as the possibility of surgical intervention.


2016 ◽  
Vol 74 (9) ◽  
pp. 745-749 ◽  
Author(s):  
Catarina C. Lins ◽  
Diego T. Prado ◽  
Andrei F. Joaquim

ABSTRACT Surgical treatment is well accepted for patients with traumatic cervical facet joint dislocations (CFD), but there is uncertainty over which approach is better: anterior, posterior or combined. We performed a systematic literature review to evaluate the indications for anterior and posterior approaches in the management of CFD. Anterior approaches can restore cervical lordosis, and cause less postoperative pain and less wound problems. Posterior approaches are useful for direct reduction of locked facet joints and provide stronger fixation from a biomechanical point of view. Combined approaches can be used in more complex cases. Although both anterior and posterior approaches can be used interchangeably, there are some patients who may benefit from one of them over the other, as discussed in this review. Surgeons who treat cervical spine trauma should be able to perform both procedures as well as combined approaches to adequately manage CFD and improve patients’ final outcomes.


2013 ◽  
Vol 542 ◽  
pp. 102-106 ◽  
Author(s):  
Nathan D. Crosby ◽  
Christine L. Weisshaar ◽  
Beth A. Winkelstein

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