Postsurgical lumbar facet joint syndrome: Therapeutic results of facet infiltration

Abstract

IntroductionPostsurgical Lumbar facet joint syndrome (PLFJS) is a clinical entity characterized by acute or chronic lumbar pain which can irradiate to the lower extremities but never with a dermatomal pattern in postsurgical patients of lumbar surgery. The diagnosis and treatment are with a Diagnostic Facet Block (DFB). This study describes the outcome of patients undergoing DFB after lumbar surgery and compares the results with patients without surgery. MethodsAn analytic and longitudinal study with patients over 18 years old between January 2018 and January 2020. For the comparative analysis, we performed two groups: non-surgical lumbar facet joint syndrome (NSLFJS) and PLFJS. ResultsThe general prevalence of PLFJS in our population was 12.5%. The results after DBF showed a significant decrease in the Oswestry percentage and pain according to the Visual Analog Scale(VAS) for the NSLFJS and PLFJS groups between the 3 surgical stages (pre-DFB, post-DFB at 6 weeks and post-DFB at 6 months), but no significant differences between the 2 groups. DiscussionThe VAS and Oswestry reported a significant improvement in both groups of patients. The innervation of the lumbar facet joints causes pain, this is secondary to the pathological neural activity of facet arthritis that arises because of chronic postsurgical inflammation or chronic degenerative changes. ConclusionThe origin of the LFJS is the arthrosis of the facet, originated by postsurgical or degenerative changes.DFB is effectivefor decreasing pain of facet joint origin in patients with previous lumbar surgery.