Lumbar Zygapophyseal Joint Injections in Patients with Chronic Lower Back Pain

Shih, Chunhsi; Lin, Gin-Yau; Yueh, Kuo-Chu; Lin, Juei‐Jueng

doi:10.1016/s1726-4901(09)70136-4

Cited by 27 publications

(25 citation statements)

References 32 publications

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“…Though the pain response gradually declines over time, even in the medium term (up to 24 weeks) as many as one-third of patients still experience significant pain relief. [10121718] Our results showed short-term relief in 86–93% of patients and medium-term relief in 62%, which compare favorably with the results of these earlier studies. In our opinion, the high number of responders in our study could be due to meticulous adherence to the patient selection criteria, with elicitation of paraspinal tenderness over the facet joint being the most important inclusion criterion.…”

Section: Discussionsupporting

confidence: 90%

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

Chaturvedi

Sivasankar

2009

Indian J Radiol Imaging

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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.

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Section: Discussionsupporting

confidence: 90%

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

Chaturvedi

Sivasankar

2009

Indian J Radiol Imaging

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“…Other possible mechanisms of facet joint pain are chronic synovial reactions and degenerative osteoarthritis. 32 In our opinion, this supports our theory that the extended removal of the intervertebral disc represents the ''major trauma'' with consecutive reduction of the intervertebral space, which potentially leads to progressive disruption of spinal stability. Recently, Parker et al calculated the enormous costs of treatment of long-term back pain in postsurgical patients with single-level LDH 33 , and the factors that sensitize patients to the postsurgical risk of spinal instability.…”

Section: Pfjs and Discectomysupporting

confidence: 82%

Predictors of facet joint syndrome after lumbar disc surgery

Steib¹,

Proescholdt²,

Brawanski³

et al. 2012

Journal of Clinical Neuroscience

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“…Several studies demonstrated the positive short and long- term effects of IA LFJ corticosteroid injection for managing LFJ pain. [10,13,14] In contrast, Lilius et al [29] reported no differences in outcome between the placebo and ICI groups. Generally, to clinicians, the level of evidence of ICIs is fair or moderate.…”

Section: Discussionmentioning

confidence: 99%

“…The intra-articular (IA) LFJ injection or lumbar medial branch block (MBB) with corticosteroid is widely and conventionally used for the management of LBP originating in the LFJ. [9–14] However, the levels of evidence for these procedures are considered fair or moderate. [15] Furthermore, corticosteroids can have several adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Comparison of intra-articular lumbar facet joint pulsed radiofrequency and intra-articular lumbar facet joint corticosteroid injection for management of lumbar facet joint pain

Hee

Ahn²,

Cho³

et al. 2017

Medicine

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Background:This study aimed to demonstrate the effect of intra-articular (IA) lumbar facet joint (LFJ) pulsed radiofrequency (PRF) for the management of LFJ pain, and to compare the effect of IA LFJ PRF to IA corticosteroid injection (ICI). Pathology in the LFJ is a common source of lower back pain (LBP). It is responsible for chronic LBP in approximately 15% to 45% of patients. It has been reported that PRF stimulation can effectively reduce refractory joint pain.Methods:Sixty patients with LFJ pain were recruited and randomly assigned to 1 of 2 groups: the IA PRF group and the ICI group. There were 30 patients in each group. At pretreatment, 2 weeks, 1, 3, and 6 months after treatment, we assessed the severity of LBP using a numeric rating scale (NRS).Results:Compared with the pretreatment NRS scores, patients in both groups showed a significant decrease in NRS scores at 2 weeks, and 1, 3, and 6 months after each treatment. Between groups, changes in the NRS scores were significantly different over time. At 2 weeks and 1 month after each procedure, the NRS score after ICI was significantly lower than that after the PRF stimulation. However, at 3 and 6 months after the procedures, the decrements of NRS scores were not significantly different between the 2 groups. Six months after treatment, about half of patients in both groups reported successful pain relief (pain relief of ≥50%).Conclusion:In the current study, both IA PRF stimulation and ICI into the LFJ significantly relieved LFJ pain. Their effects persisted for at least 6 months after the procedure. Thus, IA PRF is a useful therapeutic option for the management of LFJ pain.

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Lumbar Zygapophyseal Joint Injections in Patients with Chronic Lower Back Pain

Abstract: Lumbar zygapophyseal joint injections, as a useful diagnostic tool for facet joint syndrome, could also have useful palliative effects in the management of chronic lower back pain.

Cited by 27 publications

References 32 publications

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

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

Predictors of facet joint syndrome after lumbar disc surgery

Comparison of intra-articular lumbar facet joint pulsed radiofrequency and intra-articular lumbar facet joint corticosteroid injection for management of lumbar facet joint pain

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