Rear-End Auto Crashes: Traumatic Facet Joint Injuries

In a rear-end auto collision, spinal injuries of the neck and back often occur. A traumatic facet joint injury to the spine as a result of a rear-end auto crash is a common injury. Facet joint injuries are an “invisible” injury. A traumatic facet joint injury is usually not seen on X-rays and MRI imaging studies.

The attorneys at the law firm of Grazian & Volpe have handled hundreds of auto crash cases and understand the medicine related to a facet joint injury in the spine. In this Blog, which is part of a series on spinal injuries caused by auto accidents, we shall explain what a facet joint injury is, how a facet joint injury is diagnosed, and what is done to treat a facet joint injury.

Facet Joints

The facet joints help stabilize our spine, holding the spinal column in place and preventing excessive rotation (twisting) and flexion or extension (bending) of the spine.

Facet joints also prevent rotation of the vertebral column to a great degree. In addition, facet joints are necessary to prevent spondylolisthesis, which is forward slippage of one vertebra upon another. When this injury happens, the spinal canal gets compromised and there can be problems with pinching of the spinal cord.

Traumatic Injury to the Facet Joints

In an auto collision, the sudden impact can produce mechanical forces to the body that cause violent flexion-extension (“whiplash”) of the cervical spine or neck. See Image No. 1 below. This is also medically known as cervical acceleration-deceleration syndrome. This sudden force is transferred to the facet joints which attempt to maintain stability of the spinal vertebrae during whiplash by preventing the spine from excessively bending forward or backward. However, the facet joint can be abruptly injured by dislocation of the joint or from tearing or inflammation to the cartilage in the facet joint.

Image No. 1 Flexion-Extension X-Ray images

Image No. 1 Flexion-Extension X-Ray images

Signs and Symptoms of Facet Joint Injuries

  • Acute onset of neck, mid or low back or pain.
  • Palpable tenderness directly over the facet joints and reduced range of motion and muscle spasms.
  • In the neck, pain increases when extending backward and improves when flexing forward.
  • In the low back, pain can radiate or extend from the back to the buttocks; pain is present when standing but increases with sitting.
  • In the neck, the pain can radiate or extend from the neck onto the top of shoulders and upper shoulder blades.
  • The pain and restricted motion are recurrent and ongoing.

Diagnosis of Facet Joint Injuries

A CT-scan at the spinal level involved is the imaging study of choice for a clinically suspected facet joint injury. However, a CT-scan is only sensitive for diagnosis of damage to the facet joint fifty percent (50%) of the time.

The best diagnostic method for facet joint injuries is a medial branch block procedure. The medial branch nerves supply sensation and enervation to the facet joints. During a medial branch block procedure, an anesthetic is injected in the spine near the small medial nerves connected to a specific facet joint.¹

If the facet joint or joints targeted in the block procedure are causing the pain, then a patient will obtain relief from the medial branch nerve block; and if the facet joint is not causing the pain, then a patient will not obtain pain relief. This is what makes the procedure diagnostic for facet joint injuries. See Image No. 2 below.

Image No. 2 Medial Branch Block procedure. Needle injection of corticosteroid to nerve.

Image No. 2 Medial Branch Block procedure. Needle injection of corticosteroid to nerve.

Usually, a medial branch block is performed on two different dates, months apart, to confirm the diagnosis.

¹ Cohen SP, Moon JY, Brummett CM, White RL, Larkin TM. Medial Branch Blocks or Intra-Articular Injections as a Prognostic Tool Before Lumbar Facet Radiofrequency Denervation. Regional Anesthesia and Pain Medicine. 2015;40(4):376-383.

Long Term Treatment of Facet Joint Injuries

A procedure known as radiofrequency ablation (“RFA”) is used to treat a facet joint injury and obtain long term relief. An RFA is a minimally invasive procedure that reorganizes and modulates the nerve fibers carrying pain signals to the brain. In a radiofrequency ablation procedure, also called a rhizotomy, a probe is placed in the spine under x-ray guidance, and heat wave energy is delivered to the affected nerves. The waves “ablate,” or burn, the nerves that are causing the pain, thereby stopping pain signals from traveling along the nerves to the brain.

If you have suffered from back or neck pain due to someone’s negligence, getting an accurate diagnosis of your injuries is crucial. It is important to be informed and to utilize qualified medical professionals and experienced personal injury lawyers to help you fully recover. Call attorney Kurt D. Lloyd at Grazian & Volpe today at 773.838.8100, or fill out our online form for a free consultation.

The above article was written by Kurt D. Lloyd of Grazian & Volpe. Kurt Lloyd has been practicing personal injury law in the Chicagoland area for over 30 years and has helped his clients win more than $355 million in jury verdicts and settlements from insurance companies and corporations. Kurt helps his injured clients regain their lives after injury. The information provided comes from his extensive legal and medical research and years of experience trying injury cases in courtrooms throughout Illinois.