facetleder

Facetleder, also known as facet joints or zygapophyseal joints, are small synovial joints between the superior and inferior articular processes of adjacent vertebrae. On each side of a spinal level there is a pair of facetleder, forming a total of two joints per level. Each joint has a synovial capsule, hyaline cartilage on the articulating surfaces, and supporting ligaments. The joints are innervated mainly by the medial branches of the dorsal rami.

Facetleder contribute to spinal stability and guide movement. They help control vertebral motion, limit excessive rotation, and work together with intervertebral discs and ligaments to coordinate flexion, extension, and lateral bending. The orientation of facetleder varies by region: cervical facets are oblique and permit a wide range of motion including rotation; thoracic facets are more coronal and limit motion; lumbar facets are more sagittal and favor flexion and extension with limited rotation.

Clinical significance: facetleder can be a source of neck and back pain when they develop osteoarthritis, hypertrophy, inflammation, or injury. Pain from facetleder, often termed facetogenic pain, may be localized or referred and can mimic other spinal conditions. Imaging findings do not always correlate with symptoms, so diagnosis often relies on clinical assessment and diagnostic nerve blocks.

Treatment approaches are generally conservative first, including physical therapy, activity modification, and nonsteroidal anti-inflammatory drugs. For persistent facetogenic pain, corticosteroid injections into the facet joint or radiofrequency ablation of the medial branches can be used. In rare cases, surgical intervention may be considered for structural instability or nerve compression.