Review Article
Volume 12 Issue 3 - 2021
Understanding the Z–Joint and its Effects on Spinal Nerve Root Compression due to Specific Orthopedic Disorders
Nicholas A Kerna1-3*, Uzoamaka Nwokorie4, Abdullah Hafid5, Kevin D Pruitt6, Rashad Roberson7, Fernand Jean-Basptiste8, Silile Ndhlovu9, Shain Waugh10, and ND Victor Carsrud11
1SMC–Medical Research, Thailand
2First InterHealth Group, Thailand
3University of Washington, USA
4Academy of Integrative Health & Medicine (AIHM), USA
5Kemet Medical Consultants, USA
6Georgetown American University, College of Medicine, Guyana
7Department of Biological Sciences, Florida Atlantic University, Boca Raton, Florida, USA
8MyPainDoc PC, USA
9Fettle Path, USA
10Lakeline Wellness Center, USA
*Corresponding Author: Nicholas A Kerna, (mailing address) POB47 Phatphong, Suriwongse Road, Bangkok, Thailand 10500.
Received: January 06, 2021; Published: February 27, 2021




Abstract

Zygapophyseal joints (Z-joints) of the spine are vital for human movement, particularly postero-lateral movements (such as flexion, extension, and rotation) while contributing stability to the spine. However, when compromised, Z-joints can become sources of mild to severe and unrelenting pain. Various factors, such as aging, trauma, gender, facet orientation (tropism), impingement of spinal nerve roots, and specific orthopedic conditions—arthritis, degenerative joint disease (DJD), and degenerative disc disease (DDD)— are contributing factors. The treatment of Z-joint-elicited pain requires multimodal management, consisting of conservative therapy, surgical intervention, and adjunctive methods (such as patient education, exercise, and psychotherapy). This review describes the structure and biomechanics of the Z-joint and the relationship of the Z-joint to adjacent structures that, when compromised, cause pain. Also, descriptions of specific treatment options are provided. Although beyond this review’s scope, the growing shift towards in non-opioid analgesia is mentioned and links to two current publications by Flores and Kerna (2020) regarding such are provided in the Supplementary Note section. The structure and biomechanics of the zygapophyseal joint have been an evolutionary boon to human movement and mobility; however, when compromised, have also brought forth a plague of pain, which is problematic to treat, ameliorate, or cure.

Keywords: Apophyseal; Degeneration; Facet Syndrome; Pain; Spinal Nerve Root; Vertebrae; Zygapophyseal

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Citation: Kerna NA, Nwokorie U, Hafid A, Pruitt KD, Roberson R, Jean-Baptiste F, Ndhlovu S, Waugh S, Carsrud NDV. “Understanding the Z–Joint and its Effects on Spinal Nerve Root Compression due to Specific Orthopedic Disorders”. EC Orthopaedics 12.3 (2021): 71-81.

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