scholarly journals Minimally invasive interventional approaches for treatment of facet joint syndrome

2020 ◽  
Vol 28 (3) ◽  
pp. 71-83
Author(s):  
Dilyan Ferdinandov ◽  
Dimo Yankov
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Minimally Invasive ◽  
Significant Role ◽  
Facet Joint ◽  
Cartilage Degeneration ◽  
Joint Capsule ◽  
Low Back ◽  
Facet Syndrome ◽  
Complementary Techniques

The facet syndrome is a unilateral or bilateral pain originating from the intervertebral joint. Its frequency reaches 30% of the population of patients with low back pain. Inflammation plays a significant role in cartilage degeneration and the development of osteoarthritis, and also significantly contributes to swelling with overstretching of the joint capsule and irritation of nociceptive receptors. Minimally invasive interventional approaches play a significant role in the treatment of facet syndrome. This review systemize the ways to treat the pain through corticosteroid infiltrations and interventional denervations of the intervertebral joint, which may be complementary techniques. The literature is analyzed and our experience is presented.

Posterior Branches of Lumbar Spinal Nerves – part II: Lumbar Facet Syndrome – Pathomechanism, Symptomatology and Diagnostic Work-up

2017 ◽  
Vol 19 (2) ◽  
pp. 101-109 ◽  
Author(s):  
Katarzyna Kozera ◽  
Bogdan Ciszek ◽  
Paweł Szaro
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Facet Joint ◽  
Medial Branch ◽  
Low Back ◽  
Spinal Nerves ◽  
Lower Lumbar Spine ◽  
Facet Syndrome ◽  
Lumbar Spinal ◽  
Lumbar Facet

Posterior branches of the lumbar spinal nerves are the anatomic substrate of pain in the lower back, sacrum and the gluteal area. Such pain may be associated with various pathologies which cause pain in the posterior branches of the lumbar spinal nerves due to entrapment, mechanical irritation or inflammatory reaction and/or degeneration. The posterior branches are of significant functional importance, which is related to the function of the structures they supply, including facet joints, which are the basic biomechanical units of the spine. Low back pain caused by facet joint pathology may be triggered e.g. by simple activities, such as body rotations, unnatural positions, lifting heavy weights or excessive bending as well as chronic overloading with spinal hyperextension. Pain usually presents at the level of the lumbosacral junction (L 5 -S 1 ) and in the lower lumbar spine (L 4-5 , L 3-4 ). In the absence of specific diagnostic criteria, it is only possible to conclude that patients display tenderness at the level of the affected facet joint and that the pain is triggered by extension. Differential diagnosis for low back pain is difficult, since the pain may originate from various structures. The most reliable method of identifying Lumbar Facet Syndrome has been found to be a positive response to an analgesic procedure in the form of a block of the medial branch or intraarticular injection. There appear to be good grounds for conducting further studies and developing unequivocal diagnostic tests.

Treatment of Refractory Low Back Pain Caused by Degenerative Spine Disease with Minimally Invasive Techniques

2014 ◽  
Vol 4 (1_suppl) ◽  
pp. s-0034-1376724-s-0034-1376724
Author(s):  
K. Vladimirovich Tyulikov ◽  
K. Korostelev ◽  
V. Manukovsky ◽  
V. Litvinenko ◽  
V. Badalov
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Minimally Invasive ◽  
Low Back ◽  
Minimally Invasive Techniques ◽  
Degenerative Spine ◽  
Degenerative Spine Disease ◽  
Invasive Techniques ◽  
Spine Disease

Lumbar Facet–Mediated Pain

2016 ◽  
Author(s):  
Vikram B Patel
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lower Back Pain ◽  
Joint Pain ◽  
Facet Joint ◽  
Low Back ◽  
Lower Back ◽  
Facet Joint Pain ◽  
And Function ◽  
Lumbar Facet

Lumbar or lower back pain is a very debilitating condition that affects  almost one fifth of the adult population during a given year. Almost everyone walking on two feet is bound to suffer from some back pain during their lifetime. The health care burden for treating low back pain is enormous, especially if the lost work hours are combined with the amount used in diagnosing and treating low back pain. Lumbar facet (zygapophysial) joints are one of the major components involved in causing lower back pain. Diagnosing the pain generator is more of an art than a science. Combining various parameters in the patient’s history, physical examination, and diagnostic studies is not much different from solving a murder mystery. Although facet joint pain may be accompanied by other pain generators, that is, lumbar intervertebral disks, nerve roots, and vertebral bodies, once treated, the relief in pain is more helpful in performing proper rehabilitation and improving further deterioration in low back pain. Muscles are almost always painful due to myofascial pain syndrome that accompanies the facet joint–related pain. Treating one without addressing the other leads to failure in management and optimization of patient’s pain and function. Several treatments are available for treatment of facet joint–mediated pain, including steroid injections using a miniscule amount and radiofrequency ablation of the nerves supplying the facet joints (medial branches of the dorsal primary ramus of the lumbar nerve root). With proper diagnosis and treatment, a patient’s pain and function can be optimized to a level where it may not impact the day-to-day activities or even resumption of the patient’s routine job function. The following review describes the anatomy, pathophysiology, diagnosis, and treatment of lumbar facet joint–mediated pain.   Key words: facet joint pain, facet joint syndrome, low back pain, medial branch radiofrequency, spondylolisthesis

scholarly journals Patient education on back care

2009 ◽  
Vol 65 (1) ◽  
Author(s):  
C. Van Eck
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Patient Education ◽  
Study Design ◽  
Significant Role ◽  
The Body ◽  
Low Back ◽  
Clinical Perspective ◽  
Back Care ◽  
External Forces

Study Design: Clinical PerspectiveObjective: To provide back care education for patients with low back pain. Background:  Understanding the internal and external forces the body issubjected to, as well as the spine’s response to these forces, can better equipphysiotherapists in educating patients with low back pain. Methods and Measures: The focus of the clinical perspective is to providephysiotherapists with clinically sound reasoning when educating patients. Results: Providing a patient handout, educating them in how to incorporate back care knowledge into their dailyactivities.Conclusion: Physiotherapists can play a significant role in empowering patients through education to take responsi-bility for their disability.

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

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