![]() Facet tropism is the angular asymmetry between left and right facet joint orientation it has recently been a target of investigation as a possible risk factor able to be correlated with chronic spine pain. There are no studies to date addressing race, sex, or morbidity/mortality of facet-joint mediated pain. 4 Primary prevention is directed at modification and reduction of risk factors. Risk factors include genetics, major depression, and sedentary occupations that involve repetitive precision work with high level of muscular tension, such as data entry/management jobs. 3 Peak prevalence is in middle-aged individuals. 2 In addition, 70% of cervicogenic headaches, which are seen in 4.1% of the population, result from C2-C3 facet joint arthropathy. 1 The prevalence increases to 50-60% in trauma-induced chronic pain, including whiplash. This is in comparison to lumbar facet-mediated pain, which only accounts for 16-41% of lower back pain. In patients with localized cervical or thoracic pain, the prevalence of facet joint pain amounts to 36-67% and 34-48%, respectively. Epidemiology including risk factors and primary prevention The facet joints are often referred to as part of the “posterior elements”. Facet joints are considered part of the third, or posterior column of the spine, and usually deteriorate after the first, or anterior column, involving the intervertebral disks. It results from osteoarthritis of the facet joints, and it is a component of spondylosis, spondylolisthesis, trauma, and whiplash. Cervical and thoracic zygapophyseal joint arthropathy refers to degenerative changes in the facet joints (zygapophyseal joints, z-joints) of the spine which may result in facet-mediated head, neck, and back pain.
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