Facet Joint Technologies

[dalhousie]

I'm wondering about facet joint technologies. My problem is that I had a fusion at L1/2 where I had significant facet joint disease. My activity level is low at present & my facet joints are causing my back muscles to be in permanent spasm so I'm finding it very difficult to increase my activity level. My muscles are tense & painful all the time & have been going into intense spasms up to 3 times/week when I take Diazepam/Valium. I go out for a walk each day & try & increase that as & when I can but if I increase it a bit too much my muscles flare up pain-wise. I don't have any facet joint pain. I'm very intolerant medication-wise - such as stronger pain relief or NSAID's.

I've tried combination treatment like facet joint injections, epidurogram/epidural/nerve root injections/pulsed RF ablations. These all help but only last 2-3 weeks which is no time at all to get any fitness going. I had the epidural/nerve root injections & ablations done 7 weeks ago & the only long term benefit I've had to date is I haven't had any intense spasms requiring Diazepam/Valium - I think that must be the ablation effect, however, that may change after 8 weeks post treatment due to the injections completely wearing off.

I see my pain specialist next week so just want to be prepared before my appointment. I may be better just to keep struggling on & increasing my walking 'till my muscles are stronger so they no longer are tense & spasmed. I don't get this problem when my fitness is up & my muscles are stronger but it's just getting to that point is my problem.

I've heard of a procedure called facet joint resurfacing which I did a search on & found a thread on that by someone having it done under Dr Pimenta in Brazil. I'm in the UK & I've never heard of anybody having that done over here though.

My question is: Is there any other treatment for facet joint arthritis that anybody knows about? Or can anybody enlighten me further about facet joint resurfacing - effectiveness/risks/extent of the procedure etc.

Any input would be appreciated.

[ajj1001]

Sorry that the good effects of the RFA aren't lasting.

http://www.zygatech.com/glyder.php

This is what i think dr pimenta is using, sounds like the trial is underway in europe but can't find any details if they are still recruiting

http://zygatech.com/docs/Zyga%20Technology,%20Inc.%20Announces%20Start%20of %20European%20Enrollment%20for%20the%20GLYDER%20Fa cet%20Resurfacing%20System%20Clinical%20Study.pdf

Wouid be worth an e-mail to find out if they can give you any more details.

[Justin]

dalhousie,

It must be frustrating to only have short-lived relief from your injections and ablations. Unfortunately, these procedures provide only short-term relief for most patients. I remember reading about facet replacement systems a few years back; however, these really never panned out. I would echo what Alison relayed above: contact Dr. Pimenta regarding facet resurfacing. This might be an option for you or he could possibly suggest what might work in your situation, as he is pioneering new technology(gies).

Good luck and please keep us posted.

[dalhousie]

Sorry that the good effects of the RFA aren't lasting.

Zyga Technology Inc.| Glyder™ Facet Resurfacing System

This is what i think dr pimenta is using, sounds like the trial is underway in europe but can't find any details if they are still recruiting

http://zygatech.com/docs/Zyga Technology, Inc. Announces Start of European Enrollment for the GLYDER Facet Resurfacing System Clinical Study.pdf

Wouid be worth an e-mail to find out if they can give you any more details.

Alison - thanks for the links. I'm under the impression that FJ resurfacing is still quite experimental & in the trial stage. I haven't emailed Dr Pimenta yet but I will. The only more invasive intervention I've come across anybody having in the UK in recent years is fusing the facet joints like sarahp had under Mr Lam. I spoke to Lynda the other day & apart from what's mentioned here she suggested facet joint replacement.

I wonder whether thermal RFA's might have been more effective - they do last longer as they heat up the nerve to twice as much & burn it instead of stunning it.

Justin - In the US what type of RFA's do they tend to do - pulsed technique or thermal?


I see my pain specialist tomorrow but I don't think there's much else left to try of a conservative nature given that I don't tolerate medication very well. He did mention Tapentadol on one occasion but I've heard it can dope you up quite a lot & there's the possibility of gut side effects which I seem to be prone to. If that is the case I'll just have to keep increasing my walking as & when I can. I'm doing about 4600 steps on my walk at the moment which is nearly 2 miles & I'm hoping if I get up to 10,000 steps/4 miles my muscles will behave more normally & not be so tense/sore/spasmy - you'd think so wouldn't you?

x