Chaturvedi Arti, Chaturvedi Sunil, Sivasankar Rajiv
Indian J Radiol Imaging. 2009 Feb;19(1):29-34. doi: 10.4103/0971-3026.44522.
To assess the efficacy of facet joint infiltrations for pain relief in 44 selected patients with chronic nonradicular low back pain (LBP).
Forty-four patients with chronic LBP of more than 3 months' duration were selected for facet joint infiltration. The majority (n = 24) had facetal pain with no evidence of significant facetal arthropathy on imaging. Fifteen patients had radiological evidence of facetal arthropathy, one had a facet joint synovial cyst, three were post-lumbar surgery patients, and two patients had spondylolysis. Facet joint injections were carried out under fluoroscopic guidance in 39 patients and under CT guidance in 5 cases. Pain relief was assessed using the visual analog scale at 1 h post-procedure and, thereafter, at 1, 4, 12, and 24 weeks.
A total of 141 facet joints were infiltrated in 44 patients over a 2-year period. There was significant pain relief in 81.8% patients 1 h after the procedure, in 86.3% after 1 week, in 93.3% after 4 weeks, in 85.7% after 12 weeks, and in 62.5% after 24 weeks. No major complications were encountered.
Facet nerve block was found to be a simple, minimally invasive, and safe procedure. With meticulous patient selection, we achieved long-term success rates of over 60%. We conclude that this method represents an important alternative treatment for nonradicular back pain.
评估小关节注射对44例慢性非根性下腰痛（LBP）患者缓解疼痛的疗效。
选择44例病程超过3个月的慢性LBP患者进行小关节注射。大多数患者（n = 24）存在小关节疼痛，但影像学检查未发现明显的小关节病。15例患者有小关节病的影像学证据，1例有小关节滑膜囊肿，3例为腰椎手术后患者，2例有椎弓根峡部裂。39例患者在透视引导下进行小关节注射，5例在CT引导下进行。在操作后1小时、之后的1、4、12和24周使用视觉模拟量表评估疼痛缓解情况。
在2年期间，44例患者共进行了141次小关节注射。术后1小时81.8%的患者疼痛明显缓解，1周后为86.3%，4周后为93.3%，12周后为85.7%，24周后为62.5%。未发生重大并发症。
发现小关节神经阻滞是一种简单、微创且安全的操作。通过精心选择患者，我们获得了超过60%的长期成功率。我们得出结论，该方法是治疗非根性背痛的一种重要替代疗法。
