The Diagnostic Value of Facet Joint Injections

Moran, Raymond; O'Connell, D. J.; Walsh, M. G.

doi:10.1097/00007632-198812000-00013

Cited by 106 publications

(36 citation statements)

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“…On the other hand periarticular injection of 0.4 ml of 6% saline solution was able to create the same radiating pain as an intraarticular injection in normal volunteers did [16]. Large volumes injected intraarticularly may cause capsule rupture and fluid leakage into the epidural space, which can in part account for pain response [17]. In addition, after removal of the needle, injected substances may flow back through the injection canal into the periarticular tissue.…”

Section: Discussionmentioning

confidence: 89%

Imaging findings predicting the outcome of cervical facet joint blocks

et al. 2006

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To determine which crosssectional imaging findings predict the short-term outcome of cervical facet joint blocks (FJB) and to evaluate the effect of combined intra-/periarticular versus periarticular injection on pain. Fifty facet joints in 37 patients were included in the study. Single, unilateral FJBs in 24 patients, and bilateral single level FJBs in 13 patients were performed, respectively. In all patients, pain relief was assessed using a visual analogue scale. All computed tomography (CT) examinations were blindly reviewed by two radiologists. Osteoarthritis was rated using the Kellgren classification. The presence of combined intra-/periarticular vs. sole periarticular injection of contrast was evaluated. Kellgren Grades 0 (n=23), 1 (n=5), 2 (n=3), 3 (n=9), and 4 (n=10) were found. Mean pain relief after injection was 35% (range: 0-100%). 40% of all injections were combined intra-/periarticular. There was neither a statistically significant difference between pain relief and combined intra-/periarticular versus sole periarticular injection (p=0.64) nor the grade of osteoarthritis (p=0.49). Pain relief after cervical FJBs does not correlate with morphologic alterations seen on CT. Periarticular FJBs are not less successful than combined intra-/periarticular FJBs.

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Section: Discussionmentioning

confidence: 89%

Imaging findings predicting the outcome of cervical facet joint blocks

et al. 2006

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“…Raymond et Dumas [22] ont obtenu des résultats décevants avec les injections intraarticulaires postérieures isolées. De même, seuls 13 % des malades traités par Moran et al [23] ont répondu favorablement. La source des lombalgies est difficile à déterminer car aucun des éléments anatomiques ou radiologiques n'est corrélé aux manifestations cliniques [8,24,25].…”

Section: Discussionunclassified

Anesthésie complète des racines dorsales pour le traitement des lombalgies chroniques: étude préliminaire

Miyakoshi

Shimada

Kasukawa

et al. 2007

Revue du Rhumatisme

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“…In other studies, success rates were even lower than 18%. Raymond and Dumas [33] reported temporary relief in 16% of patients, without any long-term relief in a study of 25 patients, and Moran et al [32] reported a success rate of 13%.…”

Section: Intra-articular Injectionsmentioning

confidence: 97%

Facet joint pain and the role of neural blockade in its management

Manchikanti

1999

Current Review of Pain

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Chronic spinal pain is a common medical problem with serious financial and social consequences. Among the various structures with potential for producing pain in the spine, facet joints as sources of chronic spinal pain have attracted considerable attention and controversy. Significant progress has been made in precision diagnosis of spinal pain with neural blockade, in the face of less than optimal diagnostic information offered by imaging and neurophysiologic studies. Research into the role of facet joints in spinal pain has shown that cervical facet joints are the cause of chronic neck pain in 54% to 60% of patients, whereas lumbar facet joints cause pain in 15% to 40% of patients with chronic low back pain. Local anesthetic blocks of medial branches have proven to be a reliable diagnostic test; they are target-specific when used appropriately with control blocks, either with two local anesthetics with different durations of action or with the addition of an inactive placebo injection. The literature is replete with reports on uncontrolled studies, case reports, and documentation from a few controlled studies, all of which offer supporting information on the rationale and effectiveness of facet blocks and neurotomy. Facet joint injections and medial branch blocks are considered to be of equal value. Lumbar intra-articular steroid injections have been proven effective to a certain extent, but evidence indicates that cervical intra-articular steroids are ineffective. The role of repeat medial branch blocks is not known. Radiofrequency neurotomy remains the only practical and validated treatment for cervical facet joint pain; however, its role in management of either lumbar or thoracic facet joint pain awaits validation.

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The Diagnostic Value of Facet Joint Injections

Cited by 106 publications

References 0 publications

Imaging findings predicting the outcome of cervical facet joint blocks

Imaging findings predicting the outcome of cervical facet joint blocks

Anesthésie complète des racines dorsales pour le traitement des lombalgies chroniques: étude préliminaire

Facet joint pain and the role of neural blockade in its management

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