Lower Cervical Facet Anatomy

The lower neck takes the brunt of the whip in accidents. It is here that most often ligaments are stretched, discs are squashed and fractures happen. It's a transition zone between the highly flexible neck and the very stable (because of the ribs) thoracic spine.

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Read more … ARTHRITIS

X-ray

However, left in a "jammed-up" state, the facets will very soon start to develop degenerative arthritis (aka Osteoarthritis). Notice here the subtle changes that have been occuring since the injury. They are inevitably in the absence of the correct treatment. Understanding the Lower Cervical Facet Anatomy IS important.

• The superior end plate of the body of C4 has been lightly dinged. This is a mild compression fracture, caused by the vertebra above, as the neck whipped forwards. There would have been some internal bleeding in the bone, and swelling in the disc. The patient would have experienced some pain, and certainly stiffness, but probably not much more.
• The lower neck is very straight - a sure sign something is amiss.
• The C5 body has slipped slightly forwards on the vertebra below. This is called an anterolysthesis . The facets between C5-C6 have taken a beating.
• See the haziness of the C4-C5 facet joint (and in fact the two below it)? This is Immobilisation Arthritis forming. This joint has been fixated for several years and now it's slowly turning to concrete. Quite soon this person will be experiencing marked stiffness and difficulty rotating the neck.

On most radiological reports very little of this would be mentioned. It is considered normal aging of the spine and not worth a comment.

You can't see it on this xray, but on a scan we would most likely see bulges of the discs at one or more levels, and pressure on the nerve roots as they are being compromised from the front (by the disc), and from behind by the swollen facet joint and the progressive arthritic changes. In the early stages, you are likely to experience just nagging neck pain, but before too long it's going to cause pain in the shoulder and arm as the nerve roots are affected.

Medical admission

At the recent European Congress of Rheumatology, Prof JWJ Bijlsma, chair of the osteoarthritis scientific programme committee had this to say:

"Osteoarthritis is a real disorder, with bone and cartilage changes but, especially in the EARLY STAGES there is a discrepancy between what we see on x-ray and the clinical complaints of the patient."

Hiccuping

Read more WHY DO WE HICCUP …?

Chiropractic care

Orthopaedic researchers looking at knee and hip arthritis make the interesting statement: Mechanical factors, including joint instability and malalignment, contribute to the progressive degeneration of joints. Certainly this applies to the Cervical Facets also.

The treatment is aimed at first loosening up the fixations, treating any muscle spasm that may be present, and then exercises and rehabilitation to maintain the balance and strength in the neck.

Traction

IMPORTANT CONSIDERATIONS