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Image-guided lumbar facet joint infiltration in nonradicular low back pain.

Chaturvedi A, Chaturvedi S, Sivasankar R - Indian J Radiol Imaging (2009)

Bottom Line: Facet nerve block was found to be a simple, minimally invasive, and safe procedure.With meticulous patient selection, we achieved long-term success rates of over 60%.We conclude that this method represents an important alternative treatment for nonradicular back pain.

View Article: PubMed Central - PubMed

ABSTRACT

Objective: To assess the efficacy of facet joint infiltrations for pain relief in 44 selected patients with chronic nonradicular low back pain (LBP).

Materials and methods: Forty-four patients with chronic LBP of more than 3 months' duration were selected for facet joint infiltration. The majority (n = 24) had facetal pain with no evidence of significant facetal arthropathy on imaging. Fifteen patients had radiological evidence of facetal arthropathy, one had a facet joint synovial cyst, three were post-lumbar surgery patients, and two patients had spondylolysis. Facet joint injections were carried out under fluoroscopic guidance in 39 patients and under CT guidance in 5 cases. Pain relief was assessed using the visual analog scale at 1 h post-procedure and, thereafter, at 1, 4, 12, and 24 weeks.

Results: A total of 141 facet joints were infiltrated in 44 patients over a 2-year period. There was significant pain relief in 81.8% patients 1 h after the procedure, in 86.3% after 1 week, in 93.3% after 4 weeks, in 85.7% after 12 weeks, and in 62.5% after 24 weeks. No major complications were encountered.

Conclusions: Facet nerve block was found to be a simple, minimally invasive, and safe procedure. With meticulous patient selection, we achieved long-term success rates of over 60%. We conclude that this method represents an important alternative treatment for nonradicular back pain.

No MeSH data available.


Related in: MedlinePlus

Axial T2W MRI image at L2–3 shows advanced degenerative changes in the right facet joint (arrow).
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Figure 0001: Axial T2W MRI image at L2–3 shows advanced degenerative changes in the right facet joint (arrow).

Mentions: There were 23 men and 21 women included in the study; the ages ranged from 20–74 years. The duration of symptoms varied from 3 months to 2.5 years (mean duration: 11 months). In our patient population, the largest subgroup (23/44) had clinical signs and symptoms of facetal pain but no evidence of significant facetal arthropathy on imaging (radiography / CT / MRI). Fifteen patients had clinical as well as radiological evidence of facetal arthropathy [Figure 1], one patient had a facet joint synovial cyst [Figure 2], three were post–lumbar surgery patients, and two patients had spondylolysis at the L4–5 and L3–4 levels, respectively.


Image-guided lumbar facet joint infiltration in nonradicular low back pain.

Chaturvedi A, Chaturvedi S, Sivasankar R - Indian J Radiol Imaging (2009)

Axial T2W MRI image at L2–3 shows advanced degenerative changes in the right facet joint (arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2747413&req=5

Figure 0001: Axial T2W MRI image at L2–3 shows advanced degenerative changes in the right facet joint (arrow).
Mentions: There were 23 men and 21 women included in the study; the ages ranged from 20–74 years. The duration of symptoms varied from 3 months to 2.5 years (mean duration: 11 months). In our patient population, the largest subgroup (23/44) had clinical signs and symptoms of facetal pain but no evidence of significant facetal arthropathy on imaging (radiography / CT / MRI). Fifteen patients had clinical as well as radiological evidence of facetal arthropathy [Figure 1], one patient had a facet joint synovial cyst [Figure 2], three were post–lumbar surgery patients, and two patients had spondylolysis at the L4–5 and L3–4 levels, respectively.

Bottom Line: Facet nerve block was found to be a simple, minimally invasive, and safe procedure.With meticulous patient selection, we achieved long-term success rates of over 60%.We conclude that this method represents an important alternative treatment for nonradicular back pain.

View Article: PubMed Central - PubMed

ABSTRACT

Objective: To assess the efficacy of facet joint infiltrations for pain relief in 44 selected patients with chronic nonradicular low back pain (LBP).

Materials and methods: Forty-four patients with chronic LBP of more than 3 months' duration were selected for facet joint infiltration. The majority (n = 24) had facetal pain with no evidence of significant facetal arthropathy on imaging. Fifteen patients had radiological evidence of facetal arthropathy, one had a facet joint synovial cyst, three were post-lumbar surgery patients, and two patients had spondylolysis. Facet joint injections were carried out under fluoroscopic guidance in 39 patients and under CT guidance in 5 cases. Pain relief was assessed using the visual analog scale at 1 h post-procedure and, thereafter, at 1, 4, 12, and 24 weeks.

Results: A total of 141 facet joints were infiltrated in 44 patients over a 2-year period. There was significant pain relief in 81.8% patients 1 h after the procedure, in 86.3% after 1 week, in 93.3% after 4 weeks, in 85.7% after 12 weeks, and in 62.5% after 24 weeks. No major complications were encountered.

Conclusions: Facet nerve block was found to be a simple, minimally invasive, and safe procedure. With meticulous patient selection, we achieved long-term success rates of over 60%. We conclude that this method represents an important alternative treatment for nonradicular back pain.

No MeSH data available.


Related in: MedlinePlus