Inciting Events Associated With Lumbar Facet Joint Pain

Odonkor, Charles A.; Chen, Yi‐An; Adekoya, Peju; Marascalchi, Bryan J.; Chaudhry-Richter, Hira; Tang, Teresa; Abruzzese, Christopher; Cohen, Berklee K.; Cohen, Steven P.

doi:10.1213/ane.0000000000002242

Cited by 12 publications

(6 citation statements)

References 42 publications

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“…The results for response to RFA among age, BMI, gender, and smoking correlate with those of other studies that examined outcomes at 3 months post‐RFA 10,11 . Similarly, studies assessing patients receiving other interventional pain modalities have identified similar outcome associations.…”

Section: Resultssupporting

confidence: 75%

“…However, when examining OME units, a study by Odonkor et al found no significant difference in response to lumbar RFA for individuals on higher doses of opiates. Conversely, our study suggests improved outcomes for those on OME < 20 and a graded decrease in response as OME units are increased 11 . This association may also transcend into populations undergoing other pain procedures.…”

Section: Resultsmentioning

confidence: 58%

“…Multiple studies have analyzed the clinical predictors of success following RFA at short‐term follow‐up of 3 months 10,11 . The objective of the present study was to determine patient demographic and clinical predictors of successful response to RFA at multiple time points up to 1 year post‐RFA.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Patient Characteristics on Reported Outcomes Over 12 Months Following Lumbar Radiofrequency Ablation: A Retrospective Review of 500 Patients

et al. 2020

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Background Low back pain is the leading cause of years lost to disability worldwide. Approximately 15% to 45% of chronic low back pain is due to facet joint arthropathy. Currently, no large‐scale retrospective studies have investigated long‐term clinical predictors of success in individuals receiving radiofrequency ablation (RFA) of the medial branches for facet joint arthropathy. Objective To determine the clinical factors associated with success and failure of RFA of lumbar facet joints at 1‐year follow‐up. Methods Clinical data were gathered from 500 consecutive patients with an International Classification of Diseases (ICD)‐10 diagnosis of lumbar spondylosis. VAS pain scores for patients undergoing lumbar medial branch RFA procedures were recorded at multiple time points, up to the 1‐year follow‐up visit. A responder was defined as having ≥30% improvement in VAS score from the pre‐procedural VAS score. For our primary analysis, regression analysis was conducted to identify associations between responder status and patient characteristics, including age, gender, body mass index (BMI), hormone use, opiate dose, and smoking history at multiple time points, up to the 1‐year follow‐up visit. Results A total of 500 patients were included in the study. At the 1‐year post‐RFA follow‐up visit, responder status was associated with a lower rate of prior opioid use (43.22% vs. 55.76%, odds ratio 0.60 [95% confidence interval (CI) 0.40 to 0.92], P = 0.018), lower pre‐procedural opioid consumption in oral morphine equivalents (10.16 ± 16.02 vs. 14.67 ± 20.65, β −4.50 [95% CI −8.57 to −0.44], P = 0.030), and a higher pre‐VAS pain score (6.36 ± 2.17 vs. 5.85 ± 2.17, β 0.50 [95% CI 0.06 to 0.95], P = 0.028). There were no significant associations between responder status and age, gender, BMI, hormone use, and smoking history at the 1‐year follow‐up visit. Conclusions Our results suggest that patients prescribed opioids, particularly at higher dosages, may find less pain relief 1 year following RFA for facetogenic pain. Additionally, patients with higher pre‐procedural VAS pain scores may be more likely to have a positive response at 1 year.

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Section: Resultssupporting

confidence: 75%

Section: Resultsmentioning

confidence: 58%

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Effect of Patient Characteristics on Reported Outcomes Over 12 Months Following Lumbar Radiofrequency Ablation: A Retrospective Review of 500 Patients

et al. 2020

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“…Hohenberger et al 57 pointed out that 95.1% of patients with spinal synovial cysts had experienced local and radicular pain as the predominant symptom, and 47.5% patients appeared to have preoperative sensory and motor deficits. Particularly, Odonkor et al 58 pointed out, inciting events are common in patients diagnosed with facetogenic LBP and may be associated with a positive outcome. Hughey et al 59 showed an algorithm that compares, including starting “Oswestry disability index”, pain scores, and both gender and smoking history, favorably to that of diagnostic MBB in terms of prediction accuracy, which may improve selecting patients with LFJ syndrome.…”

Section: Clinical Presentationmentioning

confidence: 99%

Facet Joint Syndrome: Pathophysiology, Diagnosis, and Treatment

Du¹,

Xu²,

Bai³

2022

JPR

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Facet joint osteoarthritis (OA) is the most frequent form of facet joint syndrome. Medical history, referred pain patterns, physical examination, and diagnostic imaging studies (standard radiographs, magnetic resonance imaging, computed tomography and single-photon emission computed tomography) may suggest but not confirm lumbar facet joint (LFJ) syndrome as a source of low back pain (LBP). However, the diagnosis and treatment of facet joint syndrome is still controversial and needs further study. It is widely acknowledged that block with local anesthetic is perhaps the most effective method to establish a diagnosis of pain from LFJ. Particularly, there are different rates of success among different populations selected for diagnostic block with various positive criteria. Currently, in addition to conservative treatments for pain such as painkillers, functional exercises, and massage, there are many other methods, including block, denervation of the nerves that innervate the joints by radiofrequency, freezing or endoscopy, and injections. Due to the limited duration of pain relief from neurolysis of medial branch, many scholars have recently turned their targets to dorsal roots and LFJ capsules. Therefore, we reviewed the latest research progress of facet joint syndrome from diagnosis to treatment.

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“…14,67 In contrast, around half of the cases of specific spinal pain can be attributed to an inciting event, though the pathophysiological relationship between the event and etiology may be nebulous. [68][69][70] The reported incidence of space adaptation back pain in astronauts is 52% to 68%, with up to 4% experiencing severe symptoms. 14,67 The duration of space adaptation back pain generally does not exceed 12 days and has been effectively treated with oral medications, position changes (knees-to-chest), and exercise.…”

Section: Diagnosis and Treatment Considerations Of Space Adaptation B...mentioning

confidence: 99%

Back Pain in Outer Space

et al. 2021

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Space travel has grown during the past 2 decades, and is expected to surge in the future with the establishment of an American Space Force, businesses specializing in commercial space travel, and National Aeronautics and Space Administration’s planned sustained presence on the moon. Accompanying this rise, treating physicians are bracing for a concomitant increase in space-related medical problems, including back pain. Back pain is highly prevalent in astronauts and space travelers, with most cases being transient and self-limiting (space adaptation back pain). Pathophysiologic changes that affect the spine occur during space travel and may be attributed to microgravity, rapid acceleration and deceleration, and increased radiation. These include a loss of spinal curvature, spinal muscle atrophy, a higher rate of disc herniation, decreased proteoglycan and collagen content in intervertebral discs, and a reduction in bone density that may predispose people to vertebral endplate fractures. In this article, the authors discuss epidemiology, pathophysiology, prevention, treatment, and future research.

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Inciting Events Associated With Lumbar Facet Joint Pain

Abstract: Inciting events are common in patients diagnosed with lumbar facetogenic pain and may be associated with a positive outcome.

Cited by 12 publications

References 42 publications

Effect of Patient Characteristics on Reported Outcomes Over 12 Months Following Lumbar Radiofrequency Ablation: A Retrospective Review of 500 Patients

Effect of Patient Characteristics on Reported Outcomes Over 12 Months Following Lumbar Radiofrequency Ablation: A Retrospective Review of 500 Patients

Facet Joint Syndrome: Pathophysiology, Diagnosis, and Treatment

Back Pain in Outer Space

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