SPECT-CT as a Predictor of Pain Generators in Patients Undergoing Intra-Articular Injections for Chronic Neck and Back Pain

Garcia, Diogo; Sousa‐Pinto, Bernardo; Akinduro, Oluwaseun O.; Biase, Gaetano De; Filho, Leonardo José Monteiro de Macêdo; Qu, Wenchun; Atchison, James W.; Deen, H. Gordon; Nottmeier, Eric W.; Chen, Selby; Bydon, Mohamad; Sandhu, Sukhwinder J.S.; Scholten, Paul; Quiñones‐Hinojosa, Alfredo; Abode-Iyamah, Kingsley

doi:10.1016/j.wneu.2022.06.013

Cited by 13 publications

(25 citation statements)

References 25 publications

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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%

“…Twelve studies specified the injected spine levels. 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 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%

“…Pain and functional outcomes were measured using various standardized scales. Fifteen studies used a Visual Analog Scale (VAS) 21,23,[28][29][30][31][32][42][43][44][45][46][47][48][49]51,53,54 to assess pain, 9 used the Numerical Rating Pain Score, 12,24,25,27,37,38,50,55 7 used the Oswestry Disability Index, 30,31,39,40,44,51,53 which assesses pain and functional status, 3 used the Patient Global Impression of Change, which is a 7-point scale depicting a patient's 16 The figure represents the criteria for excluding papers, the distribution of studies excluded at each screening stage, and the dissection of the papers included and excluded from our review.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…Outcomes After Lumbar Facet Joint Injections • Acosta Julbe et al factors. Intervention-related factors included levels injected, 12,31,52 and dose of corticosteroid used 41,42 among others. Lastly, imaging-related factors included FJ arthropathy, 21,31,32,34,[36][37][38][42][43][44]50,52,54,55 spondylolisthesis, 31,34,36,55 and others.…”

Section: Literature Reviewmentioning

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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