Spinal Facet Joint Biomechanics and Mechanotransduction in Normal, Injury and Degenerative Conditions

Abstract

The facet joint is a crucial anatomic region of the spine owing to its biomechanical role in facilitating articulation of the vertebrae of the spinal column. It is a diarthrodial joint with opposing articular cartilage surfaces that provide a low friction environment and a ligamentous capsule that encloses the joint space. Together with the disc, the bilateral facet joints transfer loads and guide and constrain motions in the spine due to their geometry and mechanical function. Although a great deal of research has focused on defining the biomechanics of the spine and the form and function of the disc, the facet joint has only recently become the focus of experimental, computational and clinical studies. This mechanical behavior ensures the normal health and function of the spine during physiologic loading but can also lead to its dysfunction when the tissues of the facet joint are altered either by injury, degeneration or as a result of surgical modification of the spine. The anatomical, biomechanical and physiological characteristics of the facet joints in the cervical and lumbar spines have become the focus of increased attention recently with the advent of surgical procedures of the spine, such as disc repair and replacement, which may impact facet responses. Accordingly, this review summarizes the relevant anatomy and biomechanics of the facet joint and the individual tissues that comprise it. In order to better understand the physiological implications of tissue loading in all conditions, a review of mechanotransduction pathways in the cartilage, ligament and bone is also presented ranging from the tissue-level scale to cellular modifications. With this context, experimental studies are summarized as they relate to the most common modifications that alter the biomechanics and health of the spine-injury and degeneration. In addition, many computational and finite element models have been developed that enable more-detailed and specific investigations of the facet joint and its tissues than are provided by experimental approaches and also that expand their utility for the field of biomechanics. These are also reviewed to provide a more complete summary of the current knowledge of facet joint mechanics. Overall, the goal of this review is to present a comprehensive review of the breadth and depth of knowledge regarding the mechanical and adaptive responses of the facet joint and its tissues across a variety of relevant size scales.

Effect of machined interfacet allograft spacers on cervical foraminal height and area

“…4,25,26,34 Similar to other synovial joints, the facet joint can undergo progressive degeneration as a result of aging, inflammation, infection, and mechanical trauma. 15,19,30 Since the intervertebral disc and facet joint both participate in load sharing in the spine, loss of disc height or spondylolisthesis could change the normal spine biomechanics and theoretically increase the mechanical stress on the facet joint and lead to accelerated facet degeneration. 15 The cartilage in the articulating surface is one of the first components affected in the degeneration process, which can be manifested by cartilaginous loss, sclerosis, exposure of underlying bony pillars, osteophyte formation, synovial cyst formation, and capsule calcification.…”

Three-dimensional motion analysis of the cervical spine for comparison of anterior cervical decompression and fusion versus artificial disc replacement in 17 patients

“…In recent years, articular facet biomechanics has become a topic of interest, [29][30][31][32]44,52 as significant changes in relative facet motion following trauma or surgery have been suggested to induce degenerative changes in the articular cartilage. 55,65 Although studies have investigated in vivo facet kinematics at the lumbar spine, 40,44 there are no known in vivo studies that have compared different surgical techniques on facet kinematics in the cervical spine.…”

Facet Orientation and Tropism: Association With Accelerated Degeneration of Stabilizing Structures in Lower Lumbar Spine

“…Unlike intervertebral disc that allows motion in all directions and acts primarily through dissipating compressive load and resisting rotation, movements of facet joints are restricted by the form of their articulation, orientation, and capsular attachments 3 . Articular surfaces covered with hyaline cartilage provide low friction interface that facilitates motion during normal conditions in a healthy spine, while fibrous capsule resists tensile forces developing across the joint and mainly serves to limit rotation and prevent backward sliding motion during spinal extension 7,8 . Facet joints are more coronally oriented with respect to midsagittal plane in cervical and upper thoracic spine, permitting the significant range of coupled motions of axial rotation with lateral bend-V. Jeleč et al…”