Artificial facet replacement
Encyclopedia
An artificial facet replacement is a joint prosthesis
Prosthesis
In medicine, a prosthesis, prosthetic, or prosthetic limb is an artificial device extension that replaces a missing body part. It is part of the field of biomechatronics, the science of using mechanical devices with human muscle, skeleton, and nervous systems to assist or enhance motor control...

 intended to replace the natural facets
Zygapophysial joint
A zygapophysial joint is a synovial joint between the superior articular process of one vertebra and the inferior articular process of the vertebra directly above it...

 by restoring normal (or near-normal) motion while providing stabilization of spinal segments. It is typically used as an adjunct to laminectomy
Laminectomy
Laminectomy is a spine operation to remove the portion of the vertebral bone called the lamina. There are many variations of laminectomy. In the most minimal form small skin incisions are made, back muscles are pushed aside rather than cut, and the parts of the vertebra adjacent to the lamina are...

, laminotomy
Laminotomy
A laminotomy is a neurosurgical procedure that removes part of a lamina of the vertebral arch in order to decompress the corresponding spinal cord and/or spinal nerve root....

, neural decompression
Spinal decompression
Spinal decompression is a term that describes the relief of pressure on one or many pinched nerves of the spinal column.Spinal decompression can be achieved both surgically and non-surgically and is used to treat conditions that result in chronic back pain such as disc bulge, disc herniation,...

 and facetectomy
Facetectomy
Facetectomy is a surgical procedure which involves decompression of a spinal nerve root. For example, it can be performed in severely resistant cases of cervical rhizalgia, where the cervical nerve roots within the intervertebral foramina are decompressed....

, in lieu of fusion
Spinal fusion
Spinal fusion, also known as spondylodesis or spondylosyndesis, is a surgical technique used to join two or more vertebrae. Supplementary bone tissue, either from the patient or a donor , is used in conjunction with the body's natural bone growth processes to fuse the vertebrae.Fusing of the...

, for treatment of instabilities or deformities of the lumbar spine including:
  • Degenerative disease of the facets
    Facet
    Facets are flat faces on geometric shapes. The organization of naturally occurring facets was key to early developments in crystallography, since they reflect the underlying symmetry of the crystal structure...

    ;
  • Degenerative disease of the facets with instability;
  • Grade 1 degenerative spondylolisthesis
    Spondylolisthesis
    Spondylolisthesis describes the anterior or posterior displacement of a vertebra or the vertebral column in relation to the vertebrae below. It was first described in 1782 by Belgian obstetrician, Dr. Herbinaux. He reported a bony prominence anterior to the sacrum that obstructed the vagina of a...

     with objective evidence of neurologic impairment;
  • Central or lateral spinal stenosis
    Spinal stenosis
    Lumbar spinal stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and nerves at the level of the lumbar vertebra. This is usually due to the common occurrence of spinal degeneration that occurs with aging. It can also sometimes be caused by spinal disc...

    .


Facet replacements are a relatively new technology. Artificial facet replacements are currently being investigated in clinical trials in the U.S.

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