Chronic Low Back Pain: The Therapeutic Benefits of Diagnostic Medial Branch Nerve Blocks

Liu, Meilin; Shaparin, Naum; Nair, Saraswathy; Kim, Ryung S.; Hascalovici, Jacob R.

doi:10.36076/ppj.2021.24.e521

Cited by 6 publications

(24 citation statements)

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“…The first study was published in 2003. 21 Sixteen studies were prospective, [21][22][23][24][25][26][27][28][29][31][32][33]47,48,51,56 20 were retrospective, 12,30,[34][35][36][37][38][39][40][41][42][43][44][45]49,50,[52][53][54][55] and 1 was a randomized controlled trial. 46 The sample size of the included studies ranged from 12 to 3900 subjects, all with a primary diagnosis of chronic low back pain.…”

Section: Overview Of the Selected Studiesmentioning

confidence: 99%

“…21,23,28,31,[33][34][35]38,39,42,43,55 Twenty-six studies evaluated factors associated with the response after FJI, 12, whereas 11 investigated the response after MBBs. 45,[47][48][49][50][51][52][53][54][55][56] Copyright r 2023 Wolters Kluwer Health, Inc. All rights reserved.…”

Section: Overview Of the Selected Studiesmentioning

confidence: 99%

“…The person scoring the MRI scans was adequately trained to do so in 11 of 15 studies that included MRI readings in their methodology. 21,32,[34][35][36][37]39,41,50,52,55 The sample sizes for 11 of the 37 studies were <50 subjects. 21,23,[30][31][32][33]37,41,46,51,54 Each study was assigned a total score based on the number of acceptable items.…”

Section: Bias Assessment Of Selected Studiesmentioning

confidence: 99%

“…The highest possible score was 10 or 11, depending on whether the study included MRI scans. Five studies earned a total score of 11, 34,39,50,52,55 22 earned a score of 10, 12,22,[24][25][26]28,29,32,[34][35][36][37][38][40][41][42][43][44][47][48][49]53,56 8 earned a score of 9, 23,27,30,31,45,46,51,54 and 2 earned a score of 8. 21,33…”

Section: Bias Assessment Of Selected Studiesmentioning

confidence: 99%

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Predictors of Outcomes After Lumbar Intra-Articular Facet Joint Injections and Medial Branch Blocks

Acosta Julbe,

Mandell,

Ermann

et al. 2023

Spine

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Study design: A scoping review. Objective: We aimed to identify and describe the factors associated with the patient-reported response following lumbar intra-articular facet joint injections or medial branch blocks. Summary of Background Data: Facet joint osteoarthritis is among the most common causes of chronic low back pain. Management often includes facet joint intra-articular injection and medial branch blocks (which may be followed by radiofrequency ablation of the nerves innervating these joints). However, the success of these approaches is variable, prompting interest in identifying patient characteristics (imaging features, clinical signs, among others) associated with response to these types of facet injections. Methods: We performed a literature search on factors associated with patient-reported outcomes following lumbar facet joint intra-articular injections or medial branch blocks for patients with low back pain published in English or Spanish between 2000 and 2023. We excluded duplicates, papers that did not describe factors associated with outcomes, or those describing other interventions. We collected data on the association of these factors with patient-reported outcomes. Results: Thirty-seven studies met the inclusion criteria and were analyzed. These studies evaluated factors such as age, depression, and single-photon emission computed tomography (SPECT), among variables. Age and imaging findings of facet arthropathy were the most frequently described factors. Imaging findings of facet joint arthropathy and positive SPECT were often associated with positive results following intra-articular facet joint injections or medial branch blocks. In contrast, younger age and smoking were frequently associated with less favorable clinical outcomes. Conclusion: A myriad of factors were analyzed in the thirty-seven studies included in this review. Imaging findings of facet arthropathy, duration of pain, and positive SPECT were consistently associated with favorable results following facet interventions. Future prospective studies should include control groups. Clinicians may find these results useful in deciding whether to recommend facet injections.

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Section: Overview Of the Selected Studiesmentioning

confidence: 99%

Section: Overview Of the Selected Studiesmentioning

confidence: 99%

Section: Bias Assessment Of Selected Studiesmentioning

confidence: 99%

Section: Bias Assessment Of Selected Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Predictors of Outcomes After Lumbar Intra-Articular Facet Joint Injections and Medial Branch Blocks

Acosta Julbe,

Mandell,

Ermann

et al. 2023

Spine

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“…In the urban area of São Paulo, a prevalence of individuals with low back pain (LBP) of 48.1% 3 was observed and the prevalence of chronic pain in Brazil was indicated at 45.59%, ranging from 23.02 to 76.17% 4 . CLBP is considered one of the greatest causes of limitations and absence from work activities, making it not only a disease of great clinical relevance, but also economic 5 . Since it is a multifactorial condition, more than 85% of cases have no specific cause 1,6 .…”

Section: Introductionmentioning

confidence: 99%

Effect of neuromuscular electrical stimulation on muscle function in chronic low back pain patients: systematic review

Linzmeyer¹,

Coracini²,

Bertolini³

et al. 2022

BrJP

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BACKGROUND AND OBJECTIVES:Neuromuscular electrical stimulation (NMES) is one of the resources that can be used in the treatment of patients with chronic low back pain. It is possible that issues related to the stimulation parameters may affect the results obtained with the use of these currents. Therefore, the aim of this review was to investigate the effects of NMES on aspects of lumbopelvic muscle function in individuals with chronic low back pain. CONTENTS:The study is a systematic review that used 10 databases for the search through a comprehensive combination of descriptors that met the research question. The selection criteria based on the PICOT strategy were population -individuals with chronic low back pain (specific and/or non-specific); intervention -NMES; outcomes -paravertebral and/or abdominal muscle changes (muscle power and endurance). The articles were selected by two independent reviewers, who developed the tools for data extraction. Four articles were included in this review. In three of them, there was a significant increase in muscle strength and endurance, as well as muscle cross-sectional area in the group that received NMES compared to the control group. CONCLUSION: NMES showed positive effects in optimizing aspects of muscle function in individuals with chronic low back pain. However, the methods employed are very heterogeneous, which made it impossible to perform a quantitative analysis.

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Comparison of the effectiveness of ultrasound-guided versus fluoroscopy-guided medial lumbar bundle branch block on pain related to lumbar facet joints: a multicenter randomized controlled non-inferiority study

et al. 2023

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Background The aim of this multicenter randomized interventional prospective study was to compare the ultrasound (US)-guided lumbar medial branch block (LMBB) with the fluoroscopy (FS)-guided LMBB in terms of analgesic efficacy and disability in the setting of the treatment of pain arising from the lumbar facet joints (LFJ). Methods Fifty adults with a “LFJ” syndrome were randomized into two groups: in group FS, fluoroscopic-guidance was used to block the medial branch at three lumbar levels (L3-L4, L4-L5 and L5-S1); in group US, same blocks were performed under ultrasound. Needle transverse approach was used with both techniques. Effects of these procedures were assessed with a Visual Analogue Pain Scale (VAPS), the Oswestry Disability Index (ODI) and the Duke’s Activity Status Index (DASI) scale, before the treatment, 1 week and 1 month after. Hospital Anxiety and Depression Scale (HADS) score was also collected before the procedure. Analysis of variance, one (for non-inferiority) and two-sided Mann-Whitney tests and Chi-square tests were performed. Results LMBB under US-guidance was not inferior to FS-guidance (P = 0.047) in terms of VAPS, ODI and DASI at 1 week and 1 month. Duration of techniques and HADS were similar between groups (=0.34; p = 0.59). Conclusions The medial lumbar bundle branch block under ultrasound-guidance is not inferior to the fluoroscopy-guidance procedure in effectively alleviating pain arising from the facet joints. Considering that this ultrasound technique has the benefit of an irradiation-free, real-time procedure, it can be considered as an effective alternative to the fluoroscopy-guided technique.

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Chronic Low Back Pain: The Therapeutic Benefits of Diagnostic Medial Branch Nerve Blocks

Cited by 6 publications

References 0 publications

Predictors of Outcomes After Lumbar Intra-Articular Facet Joint Injections and Medial Branch Blocks

Predictors of Outcomes After Lumbar Intra-Articular Facet Joint Injections and Medial Branch Blocks

Effect of neuromuscular electrical stimulation on muscle function in chronic low back pain patients: systematic review

Comparison of the effectiveness of ultrasound-guided versus fluoroscopy-guided medial lumbar bundle branch block on pain related to lumbar facet joints: a multicenter randomized controlled non-inferiority study

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