Chang Min Cheol, Yi You Gyoung, Yang Hea-Eun, Lee Jang Ho, Kim Ji Hwan, Do Kyung Hee
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Korea.
Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea.
Ann Palliat Med. 2021 Feb;10(2):1431-1437. doi: 10.21037/apm-20-313. Epub 2020 Oct 26.
Several radiologic imaging techniques have been used to predict the effects of treatment on lumbar facet joint (LFJ) pain. However, there are no reports on the use of contrast-enhanced magnetic resonance imaging (MRI) in the management of LFJ pain. In the current study, we aimed to evaluate the clinical ability of contrast-enhanced MRI to predict treatment outcomes for LFJ pain.
A total of 26 patients with LFJ pain were recruited and intraarticular (IA) corticosteroid injections were administered to each patient. We assessed the treatment outcomes using a numerical rating scale (NRS), and two radiologists independently investigated LFJ enhancement and osteoarthritis grading. No serious complications or adverse events were reported.
IA corticosteroid injections were administered to 26 patients (12 women and 14 men; mean age: 65.19±11.05 years) with LFJ pain. Among the 26 patients, 16 patients were included in the facet joints with enhancement group, and the remaining 10 patients were included in the facet joints with non-enhancement group, based on contrast-enhanced MRI scans. In both the enhancement and non-enhancement groups, NRS scores significantly decreased at 1, 2, and 3 months after treatment (P<0.05). However, we saw no significant difference between the groups from pretreatment to three months after treatment (P>0.05).
The routine use of contrast-enhanced MRI is not recommended in patients with LFJ pain.
多种放射影像学技术已被用于预测治疗对腰椎小关节（LFJ）疼痛的效果。然而，关于使用对比增强磁共振成像（MRI）来管理LFJ疼痛尚无相关报道。在本研究中，我们旨在评估对比增强MRI预测LFJ疼痛治疗结果的临床能力。
共招募了26例LFJ疼痛患者，并对每位患者进行关节内（IA）皮质类固醇注射。我们使用数字评分量表（NRS）评估治疗结果，并且两名放射科医生独立研究LFJ强化情况和骨关节炎分级。未报告严重并发症或不良事件。
对26例（12例女性和14例男性；平均年龄：65.19±11.05岁）LFJ疼痛患者进行了IA皮质类固醇注射。根据对比增强MRI扫描结果，26例患者中，16例患者被纳入小关节强化组，其余10例患者被纳入小关节无强化组。在强化组和无强化组中，治疗后1、2和3个月时NRS评分均显著降低（P<0.05）。然而，从治疗前到治疗后三个月，两组之间未见显著差异（P>0.05）。
不建议对LFJ疼痛患者常规使用对比增强MRI。
