Bilateral Accessory C1 and C2 Facet Joints; Clinical, Neuroradiological and Peroperative Findings in an Adult with Quadriparesis

Objectives Accessory C1 and C2 facet joints are very rare. Only few cases were reported in the literature.We report a case of bilateral accessory facets in an adult with special attention to clinical, neuroradiological, as well as peroperative findings. Case report A 37-year-old male presented with progressive quadriparesis. Radiology revealed bilateral posterior accessory C1 and C2 facet joints compressing the spinal cord with craniovertebral junction (CVJ) instability. Both accessory C1 and C2 facets with the posterior arch of the C1 were removed. Lateral mass screws and plates fixation at the C1 and C2 level, as well as fusion, were performed. Postoperatively, the patient recovered well. Conclusion In accessory C1 and C2 facet joints, when symptomatic, neuroradiological findings can guide to the proper diagnosis, to pathological understanding, and, ultimately, to management strategy.

Técnicas percutáneas con ozono en el quiste facetario lumbar: serie de casos / Percutaneous treatment with ozone for the treatment of the lumbar facet joint cyst: a case series

Los quistes sinoviales de las articulaciones facetarias lumbares son intraespinales, pero extradurales. Estos quistes extradurales pueden localizarse en el ligamento intraespinoso, la articulación facetaria, el ligamento amarillo o el ligamento longitudinal anterior. Aparecen más comúnmente en la cuarta o quinta décadas de la vida y son más frecuentes en la mujer que en el hombre. Se han publicado muchas alternativas de tratamiento contra los quistes facetarios, incluidos el seguimiento, la inyección de esteroides, la aspiración percutánea del quiste, la hemilaminectomía o laminectomía bilateral con o sin fijación y la incisión mínimamente invasiva. El objetivo de este trabajo fue describir la evolución clínica y anestesiológica de una serie de pacientes con quistes facetarios, quienes recibieron tratamiento médico con ozono, sin necesidad de intervención quirúrgica. Se presentó la evolución clínica de dos pacientes a los que se les aspiró sus respectivos quistes facetarios y se les inyectó ozono. Una de ellos recidivó y se le aplicó igual tratamiento, cuya evolución ha sido satisfactoria hasta el momento. La aspiración percutánea de los quistes facetarios es un procedimiento eficaz y de mínima invasión, evita la intervención quirúrgica en la columna y la evolución es satisfactoria(AU)

Synovial cysts of the lumbar facet joints are intraspinal, but extradural. These extradural cysts can be located in the intraspinal ligament, the facet joint, the yellow ligament or the anterior longitudinal ligament. They occur more commonly in the fourth or fifth decades of life and are more frequent in women than they are in men. Many treatment alternatives for facet joint cysts have been published, including follow-up, steroid injection, percutaneous cyst aspiration, bilateral hemilaminectomy or laminectomy with or without fixation, and minimally invasive incision. The aim of this study was to describe the clinical and anesthesiological evolution of a series of patients with facet joint cysts, who received medical treatment with ozone, without the need for surgical intervention. The clinical evolution was presented of the two patients who were aspirated their respective facet joint cysts and injected with ozone. One of them relapsed and was given the same treatment, and whose evolution has been satisfactory so far. Percutaneous aspiration of facet joint cysts, an efficient and minimally invasive procedure, avoids surgical intervention in the spine and its evolution is satisfactory(AU)

Facet tropism in lumbar vertebrae and its prevalence in low back pain patients

Facet tropism is defined as asymmetry in the facet joint angles of lumbar vertebreas. in the text books there is no subject about it but there are many title and article about this anomaly and the effect of it on lumbar pain. This study tries to evaluate prevalence of facet joint tropism in the patient with low back pain. During one year, 350 patients were referred to Emam Reza Hospital due to low back pain without any ethiologic factors like acute trauma, infection, tumor or Spinal deformity. The patients were evaluated with lumbosacral radiography and for patients with asymmetry of facet joint, CT Scan was performed. Then the angle of facet joint in both sides of vertebrae was measured. Altogether the Facet tropism were seen in 68 patient [19%] and 43 cases [63%] in L5-S 1 were the most common location among these vertebreas. this study shows that facet tropism can be considered as a predisposing factor for low back pain