The effect of facet joint injection on lumbar spinal stenosis with radiculopathy

Chan Jin Park,Yoo Mee Bae,Young Duck Shin,Seung Woon Lim

doi:10.12669/pjms.344.15010

Chan Jin Park, Yoo Mee Bae + Show 2 more

Open Access

https://doi.org/10.12669/pjms.344.15010

Copy DOI

Abstract

Objectives:Facet Joint Injection (FJI) is known to be effective in axial back pain, but the purpose of this study was to assess the effects of FJI on patients treated with it among those with Lumbar Spinal Stenosis (LSS).Methods:We conducted a retrospective database analysis and investigated electronic medical records of 125 LSS patients treated with FJI in the pain clinic of Chungbuk National University Hospital from November 2, 2016 to July 31, 2017. Sex, age, histories of low back surgery, complaining of neurogenic claudication, symptomatic sites of patients, FJI sites, number of sites of FJI, triamcinolone dosage, Numeric Rating Scale (NRS) before and after treatment, facet joint capsule rupture during treatment, and improvement of neurogenic claudication after treatment, were examined.Results:Among 125 patients, we investigated 91 patients who met the criteria. There was significant difference in NRS before and after treatment (p<0.000). Forty one patients with reduction of NRS more than 30% after FJI were allocated to effect group. FJI was more effective in patients who did not have the surgery (p=0.044), as well as those who showed an improved neurogenic claudication after treatment (p=0.001). Other measured values did not show statistical significances.Conclusions:FJI has relatively a lower risk and is simpler in terms of techniques than other interventional treatments performed within the spinal canal. Therefore, FJI may be another interventional treatment option in patients with pain by LSS. In the future, studies for FJI indication in LSS patients should be additionally required.

Highlights

Lumbar Spinal Stenosis (LSS) is caused by an innate or acquired narrowing of the spinal canal
Inclusion criteria: 1) Patients complaining of characteristic symptoms of LSS such as radicular pain, radiculopathy, neurogenic claudication, and back pain; 2) Patients with radiological abnormal findings identical to symptomatic sites on Magnetic Resonance Imaging (MRI); 3) Patients confirmed to be accurately injected with contrast media to the joint space after checking Facet Joint Injection (FJI) treatment image among the patients satisfying the conditions of 1) and 2)
Exclusion criteria: 1) Patients treated with another procedure in the same day of FJI treatment; 2) Patients treated in other departments in the same day of FJI treatment; 3) Patients newly administered with opioids from the day of FJI treatment to the evaluation day; 4) Patients not examined with MRI; 5) patients without revisit records within three months

Summary

Introduction

Lumbar Spinal Stenosis (LSS) is caused by an innate or acquired narrowing of the spinal canal. Clinical characteristics of LSS include pains such as leg pain while walking and lower extremity weakness, referred as to neurogenic claudication. Along with these symptoms, they cover pain in leg segments applicable to the lumbar nerve root, as well as numbness, weakness, and loss of reflexes.[1]. Facet Joint Syndrome (FJS), a type of degenerative spondylosis, is one of the most common causes of Low Back Pain (LBP). FJS patients complain of referred pain in lower extremities. Lower lumbar FJS patients complain of referred pain in the hip and femoral region, and

Objectives

Methods

Conclusion