Hechelhammer Lukas, Pfirrmann Christian W A, Zanetti Marco, Hodler Juerg, Boos Norbert, Schmid Marius R
Radiology, University of Zurich, Balgrist Hospital, CH-8008, Zurich, Switzerland.
Eur Radiol. 2007 Apr;17(4):959-64. doi: 10.1007/s00330-006-0379-y. Epub 2006 Oct 3.
To determine which cross-sectional imaging findings predict the short-term outcome of cervical facet joint blocks (FJB) and to evaluate the effect of combined intra-/periarticular versus periarticular injection on pain. Fifty facet joints in 37 patients were included in the study. Single, unilateral FJBs in 24 patients, and bilateral single level FJBs in 13 patients were performed, respectively. In all patients, pain relief was assessed using a visual analogue scale. All computed tomography (CT) examinations were blindly reviewed by two radiologists. Osteoarthritis was rated using the Kellgren classification. The presence of combined intra-/periarticular vs. sole periarticular injection of contrast was evaluated. Kellgren Grades 0 (n=23), 1 (n=5), 2 (n=3), 3 (n=9), and 4 (n=10) were found. Mean pain relief after injection was 35% (range: 0-100%). 40% of all injections were combined intra-/periarticular. There was neither a statistically significant difference between pain relief and combined intra-/periarticular versus sole periarticular injection (p=0.64) nor the grade of osteoarthritis (p=0.49). Pain relief after cervical FJBs does not correlate with morphologic alterations seen on CT. Periarticular FJBs are not less successful than combined intra-/periarticular FJBs.
确定哪些横断面成像结果可预测颈椎小关节阻滞（FJB）的短期疗效，并评估关节内/关节周围联合注射与单纯关节周围注射对疼痛的影响。37例患者的50个小关节纳入本研究。分别对24例患者进行了单侧单节段FJB，对13例患者进行了双侧单节段FJB。所有患者均采用视觉模拟量表评估疼痛缓解情况。两位放射科医生对所有计算机断层扫描（CT）检查进行了盲法评估。采用Kellgren分类法对骨关节炎进行分级。评估了关节内/关节周围联合注射与单纯关节周围注射造影剂的情况。发现Kellgren分级为0级（n = 23）、1级（n = 5）、2级（n = 3）、3级（n = 9）和4级（n = 10）。注射后平均疼痛缓解率为35%（范围：0 - 100%）。所有注射中有40%为关节内/关节周围联合注射。疼痛缓解与关节内/关节周围联合注射与单纯关节周围注射之间（p = 0.64）以及骨关节炎分级之间（p = 0.49）均无统计学显著差异。颈椎FJB后的疼痛缓解与CT上所见的形态学改变无关。关节周围FJB并不比关节内/关节周围联合FJB效果差。
