Review articleCervical Facet Joint Dysfunction: A Review
Section snippets
Methods
A computer-aided search of several databases was performed, including Medline (1966 to present), Ovid (1966 to present), and the Cochrane database (1993 to present), using the key words cervical, zygapophyseal, whiplash, neck pain, and arthritis. In addition, we examined the references cited in these articles for key words. Selected articles were critically evaluated and had the following criteria: (1) all articles studied some aspect of cervical facet joint pain—anatomy, prevalence, etiology,
Results
We examined 46 references that consisted of 45 journal articles and relevant sections from 1 textbook. The journal articles included randomized controlled trials (RCTs), meta-analyses, uncontrolled clinical trials, uncontrolled comparison studies, nonquantitative systematic reviews, and literature-based reviews.
Pathophysiology
The cervical facet joints are diarthrodial joints formed by the articulation of the superior articular process (SAP) with the corresponding inferior articular process of the cephalad vertebrae. The SAP and inferior articular process arise from the lateral mass of the vertebrae, which is formed at the junction of the lamina and pedicle. In the upper-cervical spine the facet joints begin with an angle approximately 45° superior to the transverse plane and gradually assume a more vertical position
Conclusions
Cervical facet joints have been well established in the literature as a common source of axial neck pain, with an estimated prevalence that ranges from 25% to 66%. The diarthrodial joints are formed by bony articulation of the SAP and inferior articular process, surrounded by a fibrous capsule; they contain articular cartilage and menisci and are innervated by the medial branches of the dorsal rami. Pain from the cervical facet joints can originate from traumatic hyperextension injuries such as
References (46)
- et al.
Low back pain and the zygapophysial (facet) joints
Arch Phys Med Rehabil
(1996) - et al.
Types of synovial fold in the cervical facet joint
J Orthop Sci
(2000) - et al.
Biomechanics of the cervical spine part 3: minor injuries
Clin Biomech (Bristol, Avon)
(2001) - et al.
Comparative local anesthetic blocks in the diagnosis of cervical zygapophysial joint pain
Pain
(1993) - et al.
Referred pain distribution of the cervical zygapophyseal joints and cervical dorsal rami
Pain
(1996) - et al.
The validity of manual examination in assessing patients with neck pain
Spine J
(2007) - et al.
What you always wanted to know about the history and physical examination of neck pain but were afraid to ask
Phys Med Rehabil Clin N Am
(2003) - et al.
The cervical spine: a radiologist’s perspective
Phys Med Rehabil Clin N Am
(2003) - et al.
Pulsed radiofrequency application in treatment of chronic zygapophyseal joint pain
Spine J
(2003) - et al.
The cervical zygapophysial joints as a source of neck pain
Spine
(1988)
The cervical spine
The orientation of the articular facets of the zygapophyseal joints at the cervical and upper thoracic region
J Anat
Anatomic study of the morphology of human cervical facet joint
Spine
Demonstration of substance P, calcitonin gene-related peptide, and protein gene product 9.5 containing nerve fibers in human cervical facet joint capsules
Spine
The clinical anatomy of the cervical dorsal rami
Spine
Facet fracture-dislocation injuries of the cervical spine
Neurosurgery
Unilateral cervical facet fracture: presentation of two cases and literature review
Spinal Cord
Facet joint kinematics and injury mechanisms during simulated whiplash
Spine
Motion analysis of the cervical vertebrae during whiplash loading
Spine
Age-related changes in the cervical facet joints: studies with cryomicrometry, MR, and CT
AJR Am J Roentgenol
Discs degenerate before facets
Spine
The relationship between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI study
Eur Spine J
Early histologic changes in lower lumbar discs and facet joints and their correlation
Eur Spine J
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