A facetectomy surgery, which is sometimes referred to as a partial inferior facetectomy, or a total facetectomy, partially removes one or both of the facet joints on a set of vertebrae in the spine.
Facet joints, which are found in between the vertebrae and discs of the spine, give us the ability to bend, twist, and stand up. With age, wear and tear, or sudden trauma, these joints can become worn and rub against or pinch spinal nerves. This causes pain, numbness, and other symptoms. Patients with other spinal conditions such as degenerative disc disease and spondylosis are usually at high risk for also developing facet joint syndrome.
Lumbar facetectomy surgery is intended to relax pinched spinal nerve roots and ease the resulting pain.
FAQs About Facetectomy Surgery
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What conditions can facetectomy surgery treat?
Facetectomy surgery can be performed to relieve pain, numbness, tingling, and other symptoms caused by a variety of conditions, including:
- Deteriorated cartilage around the facet joint, known as facet joint syndrome
- Degenerative disc disease
- Degeneration of the disc spaces between the vertebrae, known as spondylosis
- Foraminal stenosis, which is the narrowing of the cervical disc space caused by enlargement of a joint; this narrowing can cause nerves to become compressed, resulting in pain
- Bone spurs
- Traumatic injury, such as fracture
How is the facetectomy procedure performed?
During facetectomy surgery, one of our expert Denver spine surgeons will make a small incision to expose the spine. At this point, the spine surgeon may need to perform either a laminotomy or a laminectomy, partially removing a lamina (a protective bony structure) to reach the facet joint.
Once the spine surgeon reaches the facet joint, he/she will remove the smallest amount possible of one or both facet joints to relieve the pressure on the pinched spinal nerves. If needed, a foraminotomy may be performed as well to relieve additional pressure on the nerve root.
The nerve roots should now be relaxed, and the spine surgeon ends the procedure by closing the incision.
The procedure typically takes between one and two hours to complete. Patients usually go home the next day.
At Neurosurgery One, our spine neurosurgeons are able to offer many patients the option of foraminotomy performed in a minimally invasive procedure.
For those who are candidates, minimally invasive foraminotomy spine surgery may provide benefits, including:
- Smaller incision
- Shorter surgical time
- Less blood loss
- Less muscle damage
- Reduced risk of infection
- Less post-surgical pain
- Faster recovery
Who is a candidate for facetectomy surgery?
The surgeons at Neurosurgery One believe surgery should be considered only when more conservative therapies such as steroid injections and physical therapy fail to provide adequate relief.
Ideal candidates for facetectomy are those who experience:
- Pain, weakness, or numbness in a leg or foot that has persisted for several months or more and does not respond to more conservative treatment
- Pain that radiates to legs
- Pain that is more severe in legs than in the back itself
- Weakness or loss of bladder and bowel control
- Difficulty performing daily activities or physical activity due to pain
- Difficulty standing or walking
In addition, at Neurosurgery One, our spine surgeons believe that surgery should be performed only when patients have a diagnosis of compressed nerves, or spinal stenosis, that is confirmed through imaging such as MRI.
What are the benefits of the facetectomy procedure?
Facetectomy surgery is often performed in combination with other spine surgeries, such as laminotomy or foraminotomy. In combination, these procedures typically provide pain relief to 90 percent of patients.
What are the risks of facetectomy spine surgery?
While risk associated with facetectomy surgery is very low, all surgical procedures carry some risks, including a very small risk of:
- Blood clots
- Nerve damage
What is the facetectomy recovery time after surgery?
Every patient’s experience is unique. However, you may expect some or all of the following after your spine surgery:
- If yours is a minimally invasive procedure, you may be able to go home the day of surgery or the following day. For open surgery, you may be hospitalized one to three days.
- You may need help with bathing, dressing, and other activities in the first few days after surgery.
- Your spine surgeon will encourage you to gradually return to normal activities, including walking. Walking short distances at first, gradually increasing to one to two miles daily, will help speed your recovery.
- Your surgeon may encourage you to wear a brace for a short time after surgery.
- You should expect to be fully recovered from surgery in four to six weeks, but you should be able to return to work and normal activities within several days to two weeks.