Manchikanti Laxmaiah, Singh Vijay, Pampati Vidyasagar, Damron Kim S, Beyer Carla D, Barnhill Renee C
Pain Management Center of Paducah, 2831 Lone Oak Road, Paducah, KY 42003, USA.
Pain Physician. 2002 Oct;5(4):365-71.
Among the chronic pain problems, pain emanating from cervical and lumbar regions, independently or in combination, constitutes a significant and frequently encountered problem in interventional pain management practices. This study was designed to test the assumption that patients presenting with chronic low back pain of lumbar facet joint origin may also present with chronic neck pain of facet joint origin. Considering that many studies show the prevalence of facet joint involvement in chronic low back pain as ranging from 15% to 45% compared to prevalence of involvement of cervical facets in chronic neck pain, ranging from 54% to 60%, we sought to evaluate the correlation between lumbar facet joint to cervical facet joint pain. One hundred twenty consecutive patients with chronic neck and low back pain were evaluated utilizing controlled diagnostic blocks with lidocaine and bupivacaine. The results showed prevalence of cervical facet joint pain in 67% of the patients with a false-positive rate of 63% with a single block, whereas the prevalence of lumbar facet joint pain was seen in 40% of the patients with a 30% false-positive rate with a single block in patients presenting with chronic low back and neck pain. There was also significant correlation noted with 94% of the patients with confirmed lumbar facet joint pain also presenting with cervical facet joint pain.
在慢性疼痛问题中，源自颈椎和腰椎区域的疼痛，单独或合并出现，在介入性疼痛管理实践中是一个重大且常见的问题。本研究旨在验证这样一个假设：患有源自腰椎小关节的慢性下腰痛的患者，也可能患有源自小关节的慢性颈部疼痛。鉴于许多研究表明，慢性下腰痛中小关节受累的患病率为15%至45%，而慢性颈部疼痛中颈椎小关节受累的患病率为54%至60%，我们试图评估腰椎小关节疼痛与颈椎小关节疼痛之间的相关性。对连续120例患有慢性颈部和下腰痛的患者使用利多卡因和布比卡因进行对照诊断性阻滞评估。结果显示，67%的患者存在颈椎小关节疼痛，单次阻滞的假阳性率为63%，而在患有慢性下腰痛和颈部疼痛的患者中，40%的患者存在腰椎小关节疼痛，单次阻滞的假阳性率为30%。此外，还发现有显著相关性，94%确诊为腰椎小关节疼痛的患者也存在颈椎小关节疼痛。
