Lumbar Facet Joint Replacement

Lumbar facet joint replacement, also known as lumbar facet arthroplasty, is an advanced surgical option that replaces arthritic or damaged facet joints in the lower back with a motion‑preserving implant. This procedure is designed to relieve pain from conditions such as spinal stenosis and degenerative spondylolisthesis, while preserving natural movement and avoiding spinal fusion.

At The Orthopedic Partners, our spine specialists, including Zach Pinter, MD, a lead investigator on the FDA study for this procedure, offer lumbar facet joint replacement to help patients maintain mobility, reduce pain, and return to active living.

What Is Lumbar Facet Joint Replacement?

Facet joints are small joints at the back of the spine that allow flexibility and stability. Over time, these joints can wear down due to arthritis, injury, or degenerative changes, leading to pain, stiffness, and nerve compression.

Lumbar facet joint replacement removes the worn or damaged facet joints and replaces them with an artificial joint implant. Unlike fusion surgery, which permanently joins two vertebrae together and limits movement, facet arthroplasty preserves motion at the treated level, helping protect the discs and joints above and below from added stress.

Benefits of Lumbar Facet Arthroplasty

Compared to spinal fusion, lumbar facet joint replacement can offer:

  • Pain relief from spinal stenosis and facet joint arthritis in the setting of a slipped vertebra (spondylolisthesis)
  • Preservation of natural movement in the lower back
  • Lower risk of adjacent segment degeneration (wear and tear above and below the treated level)
  • Faster recovery for many patients compared to fusion
  • Reduced risk of future revision surgery in certain cases

Backed by Landmark Research

Dr. Pinter of The Orthopedic Partners was a lead investigator in a large U.S. clinical trial comparing lumbar facet arthroplasty to spinal fusion for patients with lumbar spinal stenosis and grade‑I degenerative spondylolisthesis.

The study found that patients who underwent facet arthroplasty experienced:

  • Nearly three times the rate of overall treatment success compared to fusion at two years
  • Greater improvements in function, mobility, and pain reduction
  • Lower rates of complications such as new nerve symptoms and adjacent segment degeneration

These results highlight lumbar facet replacement as a safe and effective alternative to fusion for carefully selected patients.

When Is Lumbar Facet Replacement Recommended?

You may be a candidate if you have:

  • Moderate to severe lumbar spinal stenosis with nerve compression
  • Arthritic or degenerated facet joints causing pain and instability
  • Grade‑I degenerative spondylolisthesis (mild slippage of one vertebra over another)
  • Persistent symptoms despite at least six weeks of non‑surgical care
  • No severe osteoporosis, spinal deformity, or multi‑level instability

Advanced Technology for Precision

Whenever possible, our surgeons use computer‑navigated and robotic‑assisted techniques for lumbar facet joint replacement. These tools enhance surgical precision, optimize implant placement, and help ensure the best possible outcomes.

Recovery After Lumbar Facet Arthroplasty

Most patients notice significant improvement in leg and back symptoms within weeks. While recovery varies, many can:

  • Walk short distances on the day of surgery
  • Resume light exercise in a few weeks
  • Gradually increase exercise and physical therapy to restore strength and mobility
  • Return to normal activities within a few months

Because this procedure preserves motion, patients may experience a more natural feel in their spine compared to fusion.

Is Lumbar Facet Joint Replacement Right for You?

Not everyone with low back pain or spinal stenosis is a candidate for facet replacement. A thorough evaluation, including imaging, physical examination, and review of your medical history, is essential to determine if this motion‑preserving option is the right choice for your needs.

Expert Lumbar Facet Arthroplasty at The Orthopedic Partners

Our spine team is at the forefront of lumbar facet replacement, offering evidence‑based care backed by groundbreaking research. If you’re looking for relief from spinal stenosis pain and want to preserve your mobility, we’ll help you explore whether lumbar facet arthroplasty is your best path forward.

Schedule an evaluation to learn if lumbar facet joint replacement is right for you.