Injection of the facetectomy remnant in the evaluation and treatment of postsurgical back pain: case reports.

A pain syndrome encountered in patients who have undergone laminectomy with medial facetectomy is described. The patients share the following features: (a) unilateral pain, made worse by walking and standing; (b) pain in buttock, thigh, or calf; (c) normal neurologic examination; and (d) response to injection of local anesthetic/depot steroid in the area of the resected medial facet. We believe this pain is caused by neural entrapment, and thus is worsened by movement of the spinal elements. It is proposed that these facet-remnant injections might be used to identify patients who are candidates for surgical stabilization, although this supposition will require further clinical work.