A Comparison of Intraarticular Lumbar Facet Joint Steroid Injections and Lumbar Facet Joint Radiofrequency Denervation in the Treatment of Low Back Pain

2013 ◽  
Vol 117 (1) ◽  
pp. 228-235 ◽  
Author(s):  
Stefan Lakemeier ◽  
Marcel Lind ◽  
Wolfgang Schultz ◽  
Susanne Fuchs-Winkelmann ◽  
Nina Timmesfeld ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Facet Joint ◽  
Low Back ◽  
Lumbar Facet Joint ◽  
Steroid Injections ◽  
Radiofrequency Denervation ◽  
Lumbar Facet

scholarly journals Lumbar Facet Joint Nerve Blocks in Managing Chronic Facet Joint Pain: One-Year Follow-up of a Randomized, Double-Blind Controlled Trial: Clinical Trial NCT00355914

2008 ◽  
Vol 2;11 (3;2) ◽  
pp. 121-132
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Relief ◽  
Local Anesthetic ◽  
Chronic Low Back Pain ◽  
Facet Joint ◽  
Low Back ◽  
Lumbar Facet Joint ◽  
Nerve Blocks ◽  
Lumbar Facet

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

scholarly journals An Update of the Systematic Assessment of the Diagnostic Accuracy of Lumbar Facet Joint Nerve Blocks

2012 ◽  
Vol 6;15 (6;12) ◽  
pp. E869-E907
Author(s):  
Frank J.E. Falco
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Relief ◽  
Diagnostic Accuracy ◽  
Chronic Low Back Pain ◽  
Facet Joint ◽  
Low Back ◽  
Lumbar Facet Joint ◽  
Nerve Blocks ◽  
Lumbar Facet

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

scholarly journals Lumbar facet joint subchondral bone density in low back pain and asymptomatic subjects

2019 ◽  
Vol 49 (4) ◽  
pp. 571-576
Author(s):  
Chien-Chou Pan ◽  
Peter Simon ◽  
Alejandro A. Espinoza Orías ◽  
Ryota Takatori ◽  
Howard S. An ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Bone Density ◽  
Subchondral Bone ◽  
Facet Joint ◽  
Low Back ◽  
Lumbar Facet Joint ◽  
Subchondral Bone Density ◽  
Asymptomatic Subjects ◽  
Lumbar Facet

scholarly journals Are the presence of MODIC changes on MRI scans related to “improvement” in low back pain patients treated with lumbar facet joint injections?

2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Matilde Bianchi ◽  
Cynthia K. Peterson ◽  
Christian W. A. Pfirrmann ◽  
Juerg Hodler ◽  
Jennifer Bolton
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Facet Joint ◽  
Modic Changes ◽  
Low Back ◽  
Lumbar Facet Joint ◽  
Mri Scans ◽  
Pain Patients ◽  
Lumbar Facet ◽  
Joint Injections

Differences in Lumbar Facet Joint Subchondral Bone Density Between Asymptomatic and Low Back Pain Subjects

2012 ◽  
Vol 12 (9) ◽  
pp. S123
Author(s):  
Chien-Chou Pan ◽  
Peter Simon ◽  
Alejandro Espinoza Orias ◽  
Ryota Takatori ◽  
Howard S. An ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Bone Density ◽  
Subchondral Bone ◽  
Facet Joint ◽  
Low Back ◽  
Lumbar Facet Joint ◽  
Subchondral Bone Density ◽  
Lumbar Facet
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