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# Mid-back facet joints

The thoracic facet joints are pairs of small, nearly upright sliding joints at the back of the mid-back; they allow turning but little bending.

Official name: Zygapophysial (facet) joints

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## What it is

Pairs of small sliding joints at the back of the mid-back, set almost upright, which allow turning but little bending.

## What it does

Guide and limit movement (lumbar facets block twisting), and share the load with the disc, especially when you lean back.

## Key points

- At the thoracolumbar junction the facets turn from coronal to sagittal, so stress concentrates at T11–L2, the most common site of [spine](https://durgical.com/en/anatomy/region/spine/) fractures
- Each thoracic level also has costovertebral and costotransverse joints next to the facet, so mid-back joint pain has several possible sources
- Facet pain here spreads in a band across the back and toward the [chest](https://durgical.com/en/anatomy/region/chest/) wall; it must be told apart from cardiac, pleural and visceral pain

## Key facts

**Where**
Between articular processes from T1–T2 to T12–L1 (zygapophysial joints)

**Function**
Synovial plane joints; facets near the coronal plane, allow rotation and side bending, limit flexion-extension ([ribs](https://durgical.com/en/anatomy/ribs/) limit further); nerve: medial branches of dorsal rami

## Relations

**Lateral**
The costotransverse joints with the rib tubercles (T1–T10), just outside each facet

**In front**
The intervertebral foramen with the thoracic spinal nerve; in front of that, the rib head at the costovertebral joint

**Behind**
[Multifidus](https://durgical.com/en/anatomy/multifidus-muscles/), [rotatores](https://durgical.com/en/anatomy/rotatores/), [semispinalis](https://durgical.com/en/anatomy/semispinalis-muscles/) and the erector spinae; the medial branches of the dorsal rami cross near the upper outer corner of the transverse process

**Medial**
Laminae and [ligamentum flavum](https://durgical.com/en/anatomy/ligamenta-flava/); inside them, the thoracic [spinal cord](https://durgical.com/en/anatomy/spinal-cord/) in a relatively narrow canal

## How to find it

The thoracic spinous processes slant steeply downward, so in the mid-thoracic region the palpable tip lies near the level of the vertebra below; the facets and transverse processes of a vertebra therefore sit higher than its tip, a few centimetres to each side of the midline.

## Examination

- Prone springing (posteroanterior pressure) over the transverse processes: reproduction of the usual local pain suggests a facet or costotransverse source; it does not tell the two apart

## On imaging

Overlapping ribs hide them on plain radiographs. CT shows arthrosis and, after trauma, widened or perched facets in flexion-distraction injuries. Fat-suppressed MRI can show joint fluid or bone oedema around an inflamed facet.

## Common problems

- Mid-back pain from strain or arthritis.

## How it is diagnosed

There is no single sign. CT or MRI show arthritis; a numbing injection of the nerves to the joint (medial branch block) shows whether the joint is the pain source.

## Treatment

- Physical therapy and medicine; injections when needed.

## Clinical notes

- Flexion-distraction (Chance-type) injuries at the thoracolumbar junction tear the facet capsules and the posterior ligament complex; facet widening on CT signals instability
- Ankylosing spondylitis and DISH can fuse these joints; a fused thoracic spine breaks like a long bone after minor trauma
- Thoracic facet pain is confirmed with medial branch blocks, but the nerve's path over the transverse process varies more than in the lumbar spine

## Anatomical variants

- The level where the facets change from coronal to sagittal varies, usually at T11–T12 or T12–L1, and it may differ between left and right

## Test yourself

Think of the answer, then tap the question to see it.

## Which movements do the thoracic facet joints allow and limit?

Their facets lie near the coronal plane, so they allow rotation and side bending and limit flexion-extension (the ribs limit movement further).

## Why do spine fractures concentrate at T11–L2?

At the thoracolumbar junction the facets turn from coronal to sagittal, so stress concentrates there; it is the most common site of spine fractures.

## Why does a fused thoracic spine in ankylosing spondylitis or DISH need special care after minor trauma?

These diseases can fuse the thoracic facet joints, and a fused thoracic spine breaks like a long bone even after minor trauma.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
articulationes zygapophysiales TA2 1707

**Official Spanish (DeCS)**
Articulación cigapofisaria DeCS D021801

**English (TA2)**
Zygapophysial (facet) joints

**Also called**
facet joints · juncturae zygapophyseales · zygapophysial joints

## Related

- [Rib-to-spine ligaments](https://durgical.com/en/anatomy/radiate-ligament-of-head-of-rib/)
- [L1 vertebra](https://durgical.com/en/anatomy/lumbar-vertebra/)
- [T1 vertebra](https://durgical.com/en/anatomy/t1/)
- [T10 vertebra](https://durgical.com/en/anatomy/t10/)
- [T11 vertebra](https://durgical.com/en/anatomy/t11/)
- [T12 vertebra](https://durgical.com/en/anatomy/t12/)
- [T2 vertebra](https://durgical.com/en/anatomy/t2/)
- [T3 vertebra](https://durgical.com/en/anatomy/t3/)

Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=35259&filter=ths_termall&q=Articulaci%C3%B3n%20Cigapofisaria); [Anatomy, Back, Thoracic Vertebrae](https://www.ncbi.nlm.nih.gov/books/NBK459153/); Anatomy of the Human Body (20th ed.): Surface Anatomy of the Back (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain.

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/zygapophysial-joints-spine-and-pelvis-facet-joints-thoracic/