- Recovery Time
- Risks and Complications
How is a lumbar facetectomy performed?
A lumbar facetectomy is a surgical procedure to remove facet joints partially or completely in the lumbar vertebrae of the low back. Vertebrae are the chain of bones that form the backbone, which protects the spinal cord. The vertebrae are attached together by facet joints, which provide stability and flexibility to the backbone.
An orthopedic spine surgeon performs the lumbar facetectomy, typically with the patient under general anesthesia. A tube is inserted into the airway (endotracheal intubation) to assist breathing. The surgeon may administer regional or local anesthesia to numb the operative area, if the patient is unable or unwilling to undergo general anesthesia. The procedure may take approximately two hours.
What happens during the lumbar facetectomy procedure?
Prior to the surgery, the patient
- Undergoes blood and urine tests
- Undergoes imaging tests such as 3D CT scan, MRI and X-rays
- Is given antibiotics to prevent infection
- Must check with the surgeon before taking any regular medications
- Must inform the doctor of any allergies
- Must avoid eating and drinking for eight hours before the procedure
The patient lies on a special table that allows X-rays to pass through, either flat on their stomach or over a frame that arches their back up, depending on the requirement.
- Attaches an IV line for administration of anesthesia, medications and fluids.
- Performs endotracheal intubation and administers anesthesia through the IV line.
- Monitors the patient’s vital functions during the procedure.
- The patient’s nerve functions may be continuously monitored during the operation with techniques such as electromyography.
- Uses continuous X-ray (fluoroscopy) for guidance during the procedure.
- Makes a skin incision in the midline of the back or a little lateral to the midline, over the affected vertebra.
- Cuts through and retracts the tissue and muscle to expose the facet joint.
- Removes the ligament and cartilage around the joint.
- Cuts and removes the facet joint partially or entirely as required.
- May remove any herniated disc tissue or parts of bone compressing the nerve.
- May fuse the affected vertebrae together with bone graft, pedicle screws and a rod if the facet joints are removed entirely.
- Closes the incision with sutures.
The patient is
- Weaned off anesthesia and administered painkillers.
- Monitored for a few hours in the recovery room.
- Discharged from the hospital in a day or two.
What is the recovery time for a lumbar facetectomy?
The patient may need to take a week or two off work. During the healing period, patients must avoid:
- Heavy lifting
- Standing or sitting for extended periods
- Strenuous activities
If the patient has degenerative disc disease, it is advisable,
To resume normal use of the back and limbs, the patient may require:
- A lower back corset for some period
- Follow-up checkups
- Physical therapy
- Occupational therapy
Complete recovery may take six to eight weeks, however, the patient may have to be cautious not to strain their back even after the recovery period. There may be some permanent limitations to certain movements, depending on the extent of joint degeneration and complexity of surgery.
What are the risks and complications of a lumbar facetectomy?
Lumbar facetectomy is generally a safe procedure and most patients find relief from pinched nerve symptoms. As with any surgical procedure, lumbar facetectomy has certain risks including:
- Anesthetic side effects such as:
- Surgical risks such as:
- Complication that may arise include the following:
- Persistent post-operative pain and complex regional pain syndrome
- Spinal instability
- Leakage of cerebrospinal fluid
- Re-herniation of the disc or the residual fragment of facet joint
- Long-term deformity if it is a multilevel procedure for removal of tumors in facet joints
- Lack of symptom relief from the surgery
Health Solutions From Our Sponsors
Top How Is a Lumbar Facetectomy Performed Related Articles
Back Pain: Bad HabitsYou’re more likely to have back pain as you get older. Here’s how to avoid making things worse with bad habits.
16 Back Pain Truths and MythsWhich mattress is best for back pain? Back pain conditions are very common. Learn the causes of upper and lower back pain. Find the truth and get the facts behind back pain myths, remedies, causes and treatment.
Back Pain QuizThere are numerous causes of chronic lower back pain and only one ailment gets more complaints. What is it? Quiz your knowledge of symptoms, treatments, problems, and reasons for common back pain.
Fractured Spine PictureFractures of the spine (vertebra) can cause severe "band-like" pain that radiates around from the back to the side of the body. See a picture of Fractured Spine and learn more about the health topic.
Kidney Pain vs. Back PainThe signs and symptoms of kidney pain and back pain depend upon the underlying cause. Doctors may use blood tests, X-rays, CT, and/or MRI to diagnose kidney pain and back pain. Treatment may include rest, ice, stretching, muscle strengthening, and pain-relieving medications.
Lower Back PainThere are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Low Back Pain SlideshowDo you suffer from low back pain? Watch this slideshow to see common triggers of lower back pain and what kind of treatments you can get to help find relief.
Lumbar LordosisLumbar lordosis or "swayback," lower back curvature), in children, adults, and women who are pregnant is an abnormal posture with a low back curve. Symptoms of lumbar lordosis in include lower back pain and discomfort, difficulty in moving certain directions due to back pain, and a large gap or arch between the lower back and a flat surface when you lay down.
Common causes of lumbar lordosis in children, adults, and during pregnancy include obesity, kyphosis, bad posture, genetics, and other disorders of the spine. Treatment for lumbar lordosis include exercise, weight loss, surgery, and pain medication. Lumbar lordosis can be reversed and cured; however, it depends on how severe the symptoms are. Lumbar lordosis treatments may help reduce pain and other symptoms or Mild lordosis in children may be cured without treatment, while severe lumbar lordosis needs surgery to fix. Lumbar lordosis can be reversed "cured" or go back to normal or near normal.
Lumbar Spinal StenosisLumbar stenosis can be caused by degenerative arthritis (the most common cause), tumor, infection, or metabolic disorders (Paget's disease of the bone). Symptoms include low back pain, weakness, pain, numbness, and loss of sensation in the legs. Other conditions may cause similar symptoms of lumbar stenosis, including diabetic neuropathy, claudication, and peripheral vascular disease. Lumbar stenosis may be treated with medication or surgery.
Spinal FusionLower back pain is one of the most common reasons for a visit to the doctor. Lumbar spinal fusion is a surgery where the goal is to have two or more vertebrae fuse together solidly. Minimally invasive spinal fusion is an operation similar to lumbar spinal fusion, however, it a less invasive procedure. There are advantages and disadvantages of the minimally invasive spinal fusion operation.
Causes, Symptoms, Treatment for Spinal StenosisSpinal stenosis causes back pain, leg pain, difficulty walking and clumsiness. Learn the symptoms of lumbar spinal stenosis and cervical spinal stenosis and what surgeries are used for spinal stenosis treatment. Discover tips for relieving spinal stenosis pain without surgery, as well as useful medications.