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Missing Facet Joint

I was wondering if anyone here has heard of a facet joint birth defect? I was born without my L5 S1 facet joint. My spinous process at that level is misaligned and spilt in half as well. It seems to be pretty rare and I can't find much about it.



  • Hi, Emily. I came across your post while searching for information. You're right .... There's not a lot of info on this. I have found out that I was born without a left-side facet joint at L5/S1. I've had back pain on and off for most of my life, and in 2905 had my cervical spine fused at three levels due to degeneration. I've had both shoulders operated on for bone spur impingement as well. Now I think it is all related. The CT scan showed a chronic left-sided pars fracture at this level as well as severe foraminal stenosis on the right side from bone spurring.

    I have had two epidural steroid injections ... The second one just a couple of days ago. The first was a failure because doc couldn't get into the space he needed to inject the meds ... Too much spurring. The second one was successfully done but has given no relief. I have an appt on the 9th with the spine specialist who fused my neck to review all this,

    What treatment have you tried? What are your symptoms? How are you doing? :)
  • Thank you so much for replying to me!! I have felt so alone for a long time and it's nice to know I'm not! I suppose there is so little on this defect because it is extremely rare according to my research and doctors. I started having extreme low back pain 4 years ago but I can remember having slight pain when I was younger. After a few months it turned into extreme hip pain. I saw soooo many doctors, many who just walked out and said I was crazy and sent me to PT with anti inflammatory meds. Then I found a doc that said I have bursitis in my hip and a tight IT band. He wanted to do surgery so we did. Long story short I found myself back in his office still in pain and he told me I was letting the pain ruin my life and I should just be young and happy.

    So I said forget that I'm 20 years old and in extreme pain I'm not living. Finally found a doctor after about 10 of them that didn't stop looking for the problem. Turns out, an MRI I had done 4 years ago noted the defect and the doc ignored it. After a completely unnecessary surgery, wasted time and worsening pain, I'm happy to have a true diagnosis. Now I just want something to work. I've had 1 epidural injection that failed and I'm scheduled for another in a few weeks. The facet joint across from my missing one is highly arthritic and very swollen. Does yours have anything odd like that? I'm on Neurontin right now to try it and I'm really not sure about it. They've also put me on ultram as well but that does almost nothing. I honestly can't get any true relief without something stronger so I'm considering a pain specialist after my spine doctor finds the best solution.

    My main symptoms are lower back pain that is more of an achy feeling. Standing for long periods of time, sleeping and bending down to due things like laundry are pretty painful. My butt, hip and thigh burn and can get a very sharp pain in them when I walk. I also have this weird shooting pain that goes to the top of my feet which they suspect is nerve damage. My knee swells on occasion , I have horrible balance because of the defect and my hips being tilted forward by my body to protect my back and I'm really tired all the time. Have you had any hip pain? I even have tender spots on my hips that hurt when I sleep and when docs push on them.

    Again, thank you for responding. Any info you can give me about things that youve went through is greatly appreciated. Right now I'm trying to get the nasty burning pain to stop in my butt, hip and thighs because sometimes that side effect is worse than the back pain. I believe some muscles are extremely tight because they are trying to protect me but there hasn't been a very good solution to it yet. How do you feel?
  • hmcarlsonhhmcarlson Posts: 1
    edited 09/03/2013 - 6:59 PM
    WOW! I can't believe I am not alone! I have had two great things happen today! First - I finally found a doctor who could tell me what was wrong with my back and 2nd - I found this posting!

    I have spent the last 7 years in pain and refusing to give up. I saw a new doctor today who finally REALLY looked at my MRI and CAT scans and showed me that I do not have a L5/S1 facet joint. Your symptoms are exactly what mine have been.

    Are either of you still out there?

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  • cmborgeccmborge Posts: 1
    edited 08/21/2014 - 5:44 AM
    Hi everyone. So far, these posts have really helped me feel not alone. I've been having spinal pain since I was young and was diagnosed with scoliosis. Then, we checked on it a year after and it went from 7 degrees to 11 degrees (which isn't bad) BUT the doctor dismissed me saying it was due to puberty and wouldn't worsen. I am now 21 and finally went to a doctor because my entire back was in extreme pain. There would be days that I could not even bend down to tie my own shoes. My x-ray has shown that it is now at 33 degrees. I was so confused at how it could worsen that much. My first doctor told me that I have a missing joint in my lower back which has worsened it. I saw the MRI and it did seem to be missing. Then I went to get a second opinion and he said nothing is there and my spine got worse because I have "weak back muscles." I went to get my epidermal shots and trigger shots and the doctor doing it mentioned that he saw that I had a missing joint. So now i'm excited that I had a final answer to all my back pain. BUT this morning my mom got a call from the second doctor that said I did not have the missing joint saying he contacted my doctor who gave me the shots and they both agree that I don't have it and that the doctor giving me my shots misdiagnosed me. I am in a back brace and have gotten only one session of my shots, but am still in the amount of pain. I am going to see a doctor in Chicago from Western this wednesday, but i'm kind of lost as to if this has happened to anyone else.
  • I have spondylothesis grade 1 on L4/L5 with degenerative dics on L4/L5/S1. Doctors not sure what to do or know what's holding the back together due to no facet joints in the L4/L5. I have extreme pain everyday and now when I stand up most of the time the back pops. Fusion seems to be the only answer but not sure how that will work with no facets. I wanted to know if anyone has had surgery with no facet joint.
  • http://www.spine-health.com/forum/announcements/spine-health-announcements/welcome-message-resource
    Fusion surgery uses screws and rods to support the spine structures while the two vertebra are fused into one segment. The facet joints would be removed as part of the surgery, so yours being missing would not effect the surgery.
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