scholarly journals The clinical ability of contrast-enhanced magnetic resonance imaging to predict treatment outcomes for lumbar facet joint pain

2020 ◽  
Vol 9 (5) ◽  
pp. 28-28
Author(s):  
Min Cheol Chang ◽  
You Gyoung Yi ◽  
Hea-Eun Yang ◽  
Jang Ho Lee ◽  
Ji Hwan Kim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Treatment Outcomes ◽  
Joint Pain ◽  
Facet Joint ◽  
Resonance Imaging ◽  
Lumbar Facet Joint ◽  
Contrast Enhanced ◽  
Facet Joint Pain ◽  
Lumbar Facet

LUMBAR FACET JOINT ANGLE AND ITS IMPORTANCE ON JOINT VIOLATION IN LUMBAR MICRODISCECTOMY

Neurosurgery ◽  
2008 ◽  
Vol 62 (1) ◽  
pp. 168-173 ◽  
Author(s):  
Suat E. Çelik ◽  
Sevinç Çelik ◽  
Ayhan Kara ◽  
Irfan Ince ◽  
Kamber Göksu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Joint Angle ◽  
Facet Joint ◽  
Resonance Imaging ◽  
Lumbar Facet Joint ◽  
Lumbar Microdiscectomy ◽  
Surgical Corridor ◽  
Lumbar Facet

Abstract OBJECTIVE We investigated facet joint angle at the level of the nucleus pulposus in herniated disks and documented the importance of this angle in preserving articulation and surgical view in patients undergoing lumbar microdiscectomy. METHODS In this prospective study using pre- and postoperative magnetic resonance imaging scans, two blinded radiologists measured and inspected the facet joint angles in 168 patients. Patients were treated with single-level, unilateral, lumbar microdiscectomy. Postoperatively, patients were divided into two groups according to whether or not any portion of the facet joint had been violated during surgery. Using the magnetic resonance imaging scans, the angles of the facet joints were measured and then correlated with whether or not the facet joint was preserved. RESULTS The follow-up period for this study was 6 months. Postoperative radicular and back pain during the follow-up period and the need for opioids in the early postsurgery period (48 h) were higher in the nonpreserved group, but these differences were not statistically significant (P > 0.05). If the facet joint angle at the disc was lower than 35 degrees in the horizontal plane, articulation cannot be preserved. However, if this angle is greater than 35 degrees, articulation may be preserved and the surgical view is satisfactory for lumbar microdiscectomy. CONCLUSION The angle of the lumbar facet joint is important to protect articulation during lumbar microdiscectomy, and violating the facet joint may affect early postoperative pain. A facet angle of less than 35 degrees does not allow for a safe surgical corridor in which to use instruments, nor does it provide a satisfactory view for the surgeon.

scholarly journals Randomized prospective trial of cooled versus traditional radiofrequency ablation of the medial branch nerves for the treatment of lumbar facet joint pain

2019 ◽  
Vol 44 (3) ◽  
pp. 389-397 ◽  
Author(s):  
Zachary L McCormick ◽  
Heejung Choi ◽  
Rajiv Reddy ◽  
Raafay H Syed ◽  
Meghan Bhave ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Success Rate ◽  
Joint Pain ◽  
Rating Scale ◽  
Facet Joint ◽  
Prospective Trial ◽  
Medial Branch ◽  
Lumbar Facet Joint ◽  
Facet Joint Pain ◽  
Lumbar Facet

Background and objectivesNo previous study has assessed the outcomes of cooled radiofrequency ablation (C-RFA) of the medial branch nerves (MBN) for the treatment of lumbar facet joint pain nor compared its effectiveness with traditional RFA (T-RFA). This study evaluated 6-month outcomes for pain, function, psychometrics, and medication usage in patients who underwent MBN C-RFA versus T-RFA for lumbar Z-joint pain.MethodsIn this blinded, prospective trial, patients with positive diagnostic MBN blocks (>75% relief) were randomized to MBN C-RFA or T-RFA. The primary outcome was the proportion of ‘responders’ (≥50% Numeric Rating Scale (NRS) reduction) at 6 months. Secondary outcomes included NRS, Oswestry Disability Index (ODI), and Patient Global Impression of Change.ResultsForty-three participants were randomized to MBN C-RFA (n=21) or T-RFA (n=22). There were no significant differences in demographic variables (p>0.05). A ≥50% NRS reduction was observed in 52% (95% CI 31% to 74%) and 44% (95% CI 22% to 69%) of participants in the C-RFA and T-RFA groups, respectively (p=0.75). A ≥15-point or ≥30% reduction in ODI score was observed in 62% (95% CI 38% to 82%) and 44% (95% CI 22% to 69%) of participants in the C-RFA and T-RFA groups, respectively (p=0.21).ConclusionsWhen using a single diagnostic block paradigm with a threshold of >75% pain reduction, both treatment with both C-RFA and T-RFA resulted in a success rate of approximately 50% when defined by both improvement in pain and physical function at 6-month follow-up. While the success rate was higher in the C-RFA group, this difference was not statistically significant.Trial registration numberNCT02478437.

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