How was lumbosacral facet syndrome first identified?

Updated: Nov 19, 2018
  • Author: Gerard A Malanga, MD; Chief Editor: Craig C Young, MD  more...
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The first discussion of the Z-joint as a source of LBP was by Goldwaith in 1911. [8]  In 1927, Putti illustrated osteoarthritic changes of Z-joints in 75 cadavers of persons older than 40 years. [9]  In 1933, Ghormley coined the term facet syndrome, suggesting that hypertrophic changes secondary to osteoarthritis of the zygapophyseal processes led to lumbar nerve root entrapment, which caused LBP. [10]  In the 1950s, Harris and Mcnab [11]  and McRae [12]  determined that the etiology of Z-joint degeneration was secondary to intervertebral disc degeneration.

Hirsch et al were later able to reproduce LBP with injections of hypertonic saline solution into the Z-joints, thus affirming the role of the Z-joints as a source of LBP. [13]  Mooney and Robertson also performed provocative hypertonic saline Z-joint injections and recorded pain referral maps with radiation mainly to the buttocks and posterior thigh. [14]

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