OBJECT: The authors evaluated the effectiveness of using a facet joint
block with local anesthetic agents and or steroid medication for the
treatment of low-back pain in a medium-sized series of patients. METHODS:
Over a period of 4 years, the authors performed 715 facet joint injections
in 230 patients with variable-length histories of low-back pain. The
main parameter for the success or failure of this treatment was the
relief of the pain. For the first injection--mainly a diagnostic procedure--the
authors used a local anesthetic (1 ml bupivacaine 1%). In cases of good
response, betamethasone was injected in a second session to achieve
a longer-lasting effect. Long-lasting relief of the low-back pain and/or
leg pain was reported by 43 patients (18.7%) during a mean followup
period of 10 months. Thirty-five patients (15.2%) noticed a general
improvement in their pain. Twenty-seven patients (11.7%) reported relief
of low-back pain but not leg pain. Nine patients (3.9%) suffered no
back pain but still leg pain. One hundred sixteen patients (50.4%),
however, experienced no improvement of pain at all. In two cases the
procedure had to be interrupted because of severe pain. There were no
cases of infection or hematoma. CONCLUSIONS: Lumbar facet joint block
is a minimally invasive procedure to differentiate between facet joint
pain and other causes of lower-back pain. The procedure seems to be
useful for distinguishing between facet joint pain from postoperative
pain due to inappropriate neural decompression after lumbar surgery.
It can be also recommended as a possible midterm intervention for chronic
low-back pain. Bani A, Spetzger U, Gilsbach JM. Neurosurg Focus. 2002
Aug 15;13(2):E11.
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Credit: All abstracts retrieved from PubMed, developed by the National
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Library of Medicine (NLM).
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