scholarly journals Erratum: Corrigendum: 3D visualization of the lumbar facet joint after degeneration using propagation phase contrast micro-tomography

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Yong Cao ◽  
Yi Zhang ◽  
Xianzhen Yin ◽  
Hongbin Lu ◽  
Jianzhong Hu ◽  
...  
2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Yong Cao ◽  
Yi Zhang ◽  
Xianzhen Yin ◽  
Hongbin Lu ◽  
Jianzhong Hu ◽  
...  

Abstract Lumbar facet joint (LFJ) degeneration is believed to be an important cause of low back pain (LBP). Identifying the morphological changes of the LFJ in the degeneration process at a high-resolution level could be meaningful for our better understanding of the possible mechanisms underlying this process. In the present study, we determined the 3D morphology of the LFJ using propagation phase contrast micro-tomography (PPCT) in rats to assess the subtle changes that occur during the degeneration process. PPCT provides vivid 3D images of micromorphological changes in the LFJ during its degeneration process, and the changes in the subchondral bone occurred earlier than in the cartilage during the early stage of degeneration of the LFJ. The delineation of this alteration was similar to that with the histological method. Our findings demonstrated that PPCT could serve as a valuable tool for 3D visualization of the morphology of the LFJ by providing comprehensive information about the cartilage and the underlying subchondral bone and their changes during degeneration processes. It might also have great potential for providing effective diagnostic tools to track changes in the cartilage and to evaluate the effects of therapeutic interventions for LFJ degeneration in preclinical studies.


1998 ◽  
Vol 11 (5) ◽  
pp. 452???453 ◽  
Author(s):  
Atsushi Fujiwara ◽  
Kazuya Tamai ◽  
Minoru Yamato ◽  
Hiroyuki Yoshida ◽  
Koichi Saotome

2008 ◽  
Vol 2;11 (3;2) ◽  
pp. 121-132
Author(s):  
Laxmaiah Manchikanti

Background: Lumbar facet joints have been implicated as the source of chronic pain in 15% to 45% of patients with chronic low back pain. Various therapeutic techniques including intraarticular injections, medial branch blocks, and radiofrequency neurotomy of lumbar facet joint nerves have been described in the alleviation of chronic low back pain of facet joint origin. Objective: The study was conducted to determine the clinical effectiveness of therapeutic local anesthetic lumbar facet joint nerve blocks with or without steroid in managing chronic function-limiting low back pain of facet joint origin. Design: A randomized, double-blind, controlled trial. Setting: An interventional pain management setting in the United States. Methods: This study included 60 patients in Group I with local anesthetic and 60 patients in Group II with local anesthetic and steroid. The inclusion criteria was based on the positive response to the diagnostic controlled comparative local anesthetic lumbar facet joint blocks. Outcome measures: Numeric pain scores, Oswestry Disability Index, opioid intake, and work status. All outcome assessments were performed at baseline, 3 months, 6 months, and 12 months. Results: Significant improvement with significant pain relief (> 50%) and functional improvement (> 40%) were observed in 82% and 85% in Group I, with significant pain relief in over 82% of the patients and improvement in functional status in 78% of the patients. Based on the results of the present study, it appears that patients may experience significant pain relief 44 to 45 weeks of 1 year, requiring approximately 3 to 4 treatments with an average relief of 15 weeks per episode of treatment. Conclusion: Therapeutic lumbar facet joint nerve blocks, with or without steroid, may provide a management option for chronic function-limiting low back pain of facet joint origin. Key words: Chronic low back pain, lumbar facet or zygapophysial joint pain, facet joint nerve or medial branch blocks, comparative controlled local anesthetic blocks, therapeutic lumbar facet joint nerve blocks


2012 ◽  
Vol 6;15 (6;12) ◽  
pp. E869-E907
Author(s):  
Frank J.E. Falco

Background: Lumbar facet joints are a well recognized source of low back pain and referred pain in the lower extremity in patients with chronic low back pain. Conventional clinical features and other non-invasive diagnostic modalities are unreliable in diagnosing lumbar zygapophysial joint pain. Controlled diagnostic studies with at least 80% pain relief as the criterion standard have shown the prevalence of lumbar facet joint pain to be 16% to 41% of patients with chronic low back pain without disc displacement or radiculitis, with a false-positive rate of 17% to 49% with a single diagnostic block. Study Design: A systematic review of the diagnostic accuracy of lumbar facet joint nerve blocks. Objective: To determine and update the diagnostic accuracy of lumbar facet joint nerve blocks in the assessment of chronic low back pain. Methods: A methodological quality assessment of included studies was performed using Quality Appraisal of Reliability Studies (QAREL). Only diagnostic accuracy studies meeting at least 50% of the designated inclusion criteria were utilized for analysis. Studies scoring less than 50% are presented descriptively and analyzed critically. The level of evidence was classified as good, fair, and limited or poor based on the quality of evidence developed by the United States Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to June 2012, and manual searches of the bibliographies of known primary and review articles. Outcome Measures: Studies must have been performed utilizing controlled local anesthetic blocks. Pain relief was categorized as at least 50% pain relief from baseline pain and the ability to perform previously painful movements. Results: A total of 25 diagnostic accuracy studies were included. Of these, one study evaluated 50% to 74% relief as criterion standard with a single block with prevalence of 48%, 4 studies evaluated 75% to 100% relief as the criterion standard with a single block with a prevalence of 31% to 61%, 5 studies evaluated 50% to 74% relief as the criterion standard with controlled blocks with a prevalence of 15% to 61%, and 13 studies evaluated 75% to 100% relief as the criterion standard with controlled blocks with a prevalence of 25% to 45% in heterogenous populations. False-positive rates ranged from 17% to 66% in the 50% to 74% pain relief group and 27% to 49% with at least 75% relief as the criterion standard. Based on this evaluation, the evidence showed that there is good evidence for diagnostic facet joint nerve blocks with 75% to 100% pain relief as the criterion standard with dual blocks and fair evidence with 50% to 74% pain relief as the criterion standard with controlled diagnostic blocks; however, the evidence is poor with single diagnostic blocks of 50% to 74%, and limited for 75% or more pain relief as the criterion standard. Limitations: The shortcomings of this systematic review of the accuracy of diagnostic lumbar facet joint nerve blocks include a paucity of literature and continued debate on an appropriate gold standard. Conclusion: There is good evidence for diagnostic facet joint nerve blocks with 75% to 100% pain relief as the criterion standard with dual blocks, with fair evidence with 50% to 74% pain relief. Key words: Chronic low back pain, lumbar facet or zygapophysial joint pain, facet joint nerve blocks, medial branch blocks, controlled comparative local anesthetic blocks


Spine ◽  
1995 ◽  
Vol 20 (11) ◽  
pp. 1304-1306 ◽  
Author(s):  
Dirk M. Dauwe ◽  
Jan J. Van Oyen ◽  
Ignace R. Samson ◽  
Michel J. Hoogmartens

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