Identifying Refractory Facet Pain
Common symptoms and physical findings of facet pain may include:
- Somatic (non-radicular) low back pain
- Paraspinal tenderness, bilateral or unilateral
- Possible improvement of pain with spinal flexion
- Possible traumatic onset (motor vehicle accident, etc)
- Negative femoral stretch and straight leg test
While signs and symptoms may help focus a clinical investigation, the recognized standard for confirmation of a facet pain diagnosis remains diagnostic facet injection. An initial diagnosis may be achieved when a medial branch block (MBB) provides greater than 75% relief of pain. It is often recommended that a confirmatory injection be performed to reduce likelihood of false positives.
When to Consider Facet Restoration
If conservative care has failed to provide adequate relief of symptoms, it may be appropriate to consider facet restoration for treatment of refractory facet pain. Patients who have received relief from facet injections or facet denervation, but find them inadequate due to duration of relief or frustration with repeated interventions, may be good candidates for the Glyder procedure.
At this stage, a radiological investigation is also important. Utilizing MR or CT imaging, prospective patients should be evaluated for the following:
- Presence of sufficient cartilage for device fixation
- Absence of large osteophytes or severe facet joint curvature that may hinder implantation
While it is possible to remove small osteophytes blocking the dorsal entrance to the facet joint, removal of large osteophytes consistent with Grade 3 (Weishaupt) degeneration may lead to complications.
If a candidate has failed conservative care, received significant relief from facet joint injections, and meets the radiographic requirements for successful implantation, they may be a good fit for the Glyder Facet Restoration Procedure.
The Glyder device is currently enrolling clinical study patients in the United States. If you have a patient who is interested or who may be a candidate for the Glyder Facet Restoration Procedure, contact us to learn more about procedure availability.
Enrollment has been completed in a 40-patient study of the Glyder Facet Restoration Device, the GLISSADE Study. The study was completed at 4 sites in Germany and Brazil. Early data suggest that facet restoration may be a viable treatment option in select patients with chronic lumbar facet pain, with therapeutic benefit persisting at 1 year follow-up. Visit our Facet Restoration Clinical Data page to view the results of this investigation.
CAUTION: Investigational Device. Limited by Federal (United States) law to use in clinical investigations.