Facet Joint Replacement for the Treatment of Degenerative Spine Conditions

The facet joint is the vertebrae articular processes conjunction, covered with cartilage and closed by the synovial bag. These elements protect the intervertebral discs from excessive stretching (e.g., when the body bends and turns). Injuries and certain diseases can often cause changes in the intervertebral discs’ integrity, with a significant load on the facet joints. That’s how inflammation (spondyloarthritis) appears, due to which degeneration (spondyloarthritis) occurs.

The facet syndrome in question most often manifests itself in old age, but it can also disturb non-disabled adults. The recurrent nature of the disease often leads to disability or to the emergence of irreversible phenomena in the body that significantly reduce the patient’s quality of life. 

Conservative medicine is used in the early stages, but later, when serious changes are observed, surgical intervention is indispensable. In any case, remission will be longer than with drug treatment in combination with pain relievers. 

What is Facet Joint Replacement, is it worth doing such an operation, is there an alternative to spinal fusion, how the preparation takes place, and why the results may be disappointing – we’ll discuss it further. 

Degenerative spine conditions

The gradual loss of the spine’s structure and functionality is an aging characteristic and degenerative processes signal. Often such conditions can cause arthritis, tumors, infections. 

Over time, the disease progresses; however, the generally accepted picture of symptoms doesn’t always manifest itself and can differ not only in nature but in severity. There is no consensus on diagnosing the disease in the medical literature: it’s rather associated with point manifestations during several years of observation. Note that spinal disc degeneration is often the cause of stenosis, osteoarthritis, scoliosis, and spondylolisthesis. 

Symptoms of the disease

An illness is often observed in the cervical, and lumbar spine as these areas are most in motion. Its symptoms are continuous pain near the degenerating disc, leading to disability. 

Varying load and any activity can provoke pain outbreaks. Often, the symptoms include the occurrence of discomfort in the spine associated with twisting and bending, lifting something heavy. It seems that the spine cannot withstand such loads! The resulting muscle tension is accompanied by spasms, which alternate with temporary relaxation. 

The nature of pain is a degenerative disease that is different and can be modified to stitching, acute, hot. However, certain positions (such as sitting, reclining, or a pillow under your knees) can relieve unwellness.

It’s important to note that the degree of disc degeneration doesn’t depend on the severity of pain – people may not experience it at all while suffering from the disease. For this reason, the diagnosis occurs after a complete medical examination, collection of data on the patient’s complaints and medical history. 

Facet Joint Replacement

It’s a surgical procedure to replace the facet joint with stabilizing structures that connect the vertebrae. Historically, conservative treatment has included drug therapy to slow down joint degradation. In addition, blockade (injection of a local anesthetic) and rhizotomy (dissection of the nerve roots of the spinal canal) weren’t successful. The pain didn’t stop, and the risk of complications increased after the operation. Such procedures ended with fusion, which completely immobilized a particular spine area. 

However, in the past few years, the development in methodology has shown the world new possibilities with the implantation of structures that give a wide range of movements, including bending and twisting. TOPS™  are implants that belong to the group of minimally invasive ones, respectively, and the healing process will be much faster. The replacement process removes a diseased or dysfunctional joint and its substitution with a prosthetic implant. Thus, the spine’s stability is increased, and the compression of the nerve roots is reduced. The procedure preserves the spine’s standard structure, which allows you to maintain full mobility and flexibility of the vertebral elements.

Preparing for surgery

Data regarding the prognosis of surgical facet joint replacement depend on the preoperative preparation of the patient as well as his physical condition and age. For example, due to degenerative processes, the bones of older people are demineralized, which leads to their fragility. Therefore, the merger procedure may have more negative consequences than promising recovery and relief from pain. Conversely, Premia Spine’s TOPS™ structure can reduce the pressure on the screws. At the same time, they can withstand heavy loads that aren’t available to interspinous and interlaminar devices. 

Regardless of the patient’s age, preparation for surgery should include constant mobility, proper nutrition, and massages. It is essential to exclude alcohol from the diet, stop smoking, and utilize drugs – the whole point is that they impair the blood supply, respectively, healing will take place more slowly, and the body’s susceptibility to infections will increase. 

Note! In case of demineralization and insufficient secretion of osteoblasts, add mineral and vitamin complexes to the diet but first consult with your doctor.

Recovery after surgery

TOPS™ system delivers superior patient recovery results. Thus, observation of patients for seven years showed that patients recovered successfully in 86% of operations. That’s a significant advantage of the implant compared to the fusion technique, where only 64% could stand on their feet. 

Recovery after TOPS™ implantation progresses rather quickly – within 4-6 weeks, the patients can already return to their usual activities and sports. So compared to a fusion, it’ll take about six months, and for laminectomy, this period will be approximately 3-4 months. 

While being at home, try to walk and exercise lightly every day. At first, it can be pretty tricky because several rules for sleep and training maintain muscle and spine tone during the early recovery period. You’ll also need to avoid lifting objects heavier than 8 pounds and not driving for 2-4 weeks. Immune nutrition, as well as taking painkillers, will also become a trigger for recovery. In general, you need to follow your doctor’s instructions and not self-medicate.


The answers to questions related to the spine’s health often baffle patients: they don’t understand the dangers of specific surgical interventions. They may neglect their safety in the pre- and postoperative periods. But it’s important to note that sooner or later degenerative processes will occur in every person’s body. Its symptoms can be treated in two ways: conservatively when the likelihood of remission isn’t so high, and operational to maintain a high quality of life for many years. E.g., the procedure of fusion or laminectomy often causes several complications and is ineffective for the patient. They have been replaced by a new generation of TOPS™ implants from Premia Spine, which preserve the entire range of movements and allow you to maintain the structure of the spine in minimally invasive surgery. It’s up to you to decide what to choose, but you’d always consider the forecasts for recovery.