Lijec̆nic̆ki vjesnik
-
Lijec̆nic̆ki vjesnik · Sep 2011
Review[Lumbosacral facet syndrome: functional and organic disorders of lumbosacral facet joints].
Disorders of lumbosacral (LS) facet joints are manifested by low back pain with or without referred leg pain and decreased mobility of the LS spine (LS facet syndrome). The most frequent causes of LS facet syndrome are functional disorders (functional blockade or dysfunction of facet joint=reversible restriction of facet joint movements caused by meniscoid entrapment) and degenerative changes of facet joints while the others are less frequent (spondyloarthropathies, infection, tuberculosis, synovial cyst, injury). Although it has been proven that the facet joints are one of the most frequent sources of chronic low back pain (15-45%), the fact is that the facet syndrome has been frequently overlooked in patients with chronic low back pain. ⋯ Acute LS facet syndrome caused by dysfunction of facet joints responds very well to manual therapy. The most important therapeutic options in patients with chronic LS facet syndrome caused by degenerative changes and/or dysfunction of facet joints are manual therapy, kinesiotherapy (flexion exercises), therapeutic blocks and radiofrequency denervation. The article describes etiopathogenesis, clinical manifestations, diagnosis, differential diagnosis and therapy of LS facet syndrome with emphasis on functional disorders of facet joints that can cause particular diagnostic and therapeutic problems.