Lumbar facet joint syndrome. A randomised clinical trial

Abstract

A group of 109 patients with unilateral low back pain for over three months were randomised to receive one of three types of injection treatment: cortisone and local anaesthetic injected into two facet joints (28), the same mixture around two facet joints (39), or physiological saline into two facet joints (42). The effect of the treatment was evaluated in relation to work attendance, pain, disability and movements of the lumbar spine. Patients were examined one hour and two and six weeks after treatment and also completed a questionnaire after three months.

Intra-articular facet joint injections for low back pain: a systematic review

“…We included six trials with a total of N = 434 participants (range 18-109 participants); Lilius [26], Carette [27], Mayer [28], Celik [29], Kawu [30] and Ribeiro [31].…”

“…Two trials (Carette [27], Mayer [28]) included a diagnostic injection, into the facet joints, one trial, (Ribeiro [31]) used a combination of clinical and radiological assessment. The remaining three Lilius [26], Celik [29], and Kawu [30] used a clinical assessment only. The inclusion criteria fall under four broad headings these are: pain intensity or duration, physical tests, diagnostic tests, or more general criteria (see Table 1).…”

“…Lilius [26] had two intervention groups who either had injections into the facet joints (intra-articular) or injections 'around' the facet joints (peri-capsular). These two groups were pooled for the final comparison.…”

“…Three trials used a combination of bupivacaine hydrochloride (local anaesthetic) and methyl-prednisolone (corticosteroid) in various volumes and concentrations (Lilius [26], Celik [29], Kawu [30]). Carette used a combination of methyl-prednisolone and saline (no local anaesthetic).…”

“…Two trials Lilius [26] and Carette [27] used intra-articular saline as a placebo control, whilst Ribeiro [31] used active injections into para-spinal muscles as a sham control.…”