Evaluation of facet joint after lumbar partical discectomy

C. Hessler, M. Vollmer, A. Uhlenbrock, K. Sellenschloh, F. Raimund, K. Püschel, M. Westphal, M.M. Morlock, G. Huber

A considerable part of patients undergoing partial discectomy at the lumbar spine suffer from postdiscectomy-syndrome. The results from the clinical as well as the radiological diagnostic suggest that an arthrosis of the facet joints is casual for this disease. An association between a partial discectomy and the development of a facet joint arthrosis is still unproven.

Under continuous physiologic axial compression and extension-flexion load application L2-L3 and L4-L5 human cadaveric functional units were consecutively tested intact and after partial discectomy. Using a spinal loading simulator and a motion measurement system facet joint motion were statistically compared between the various specimens.

If the results of this study detect an increase in localized facet joint motion after partial discectomy, a new discussion about modified surgical procedures is necessary (e.g. intraoperative stiffening of the facet joints). At least concerned patients should be enlightened about the potential acceleration of facet joint arthrosis after partial discectomy.

This study is financially supported by the Ministry for Social and Family Affairs, Health and Consumer Protection, Hamburg.