Management of low back pain with facet joint injections and nerve root blocks under computed tomography guidance. A prospective study.
OBJECTIVE
The aim of this work was to assess the performance of facet joint and nerve root infiltrations under computed tomography guidance for the management of low back pain and to investigate the complications and patient tolerance.


METHODS
The study was board-certified and informed consent was obtained from all patients. In 1 year, 86 consecutive patients (47 male, 39 female, age range 47-87 years, mean age 63) with low back pain for more than 2 years were included. All patients were clinically examined and had cross-sectional imaging performed before the procedure. Fifty-five facet joint infiltrations and 31 nerve blocks were performed under computed tomography guidance. All patients completed two valid pain questionnaires before and 3 months after the procedures. At the same time, they were clinically examined by the referring Orthopaedic Surgeon. The pain response was assessed by comparing the scores of the questionnaires. The improvement in clinical examination findings was assessed as well.


RESULTS
In patients who underwent facet joint infiltrations, long-term pain improvement was achieved in 79% and in those with nerve blocks in 85%. Immediate pain relief was demonstrated in 83% of patients with nerve infiltrations. No complications were observed. All procedures were very well tolerated by patients.


CONCLUSIONS
Facet joint and nerve infiltrations under computed tomography guidance constitute an accurate and safe method that could be used to relieve low back pain and minimize the risk of disability.
Hinchingbrooke Hospital NHS Trust, Huntingdon, PE29 6NT, Cambridgeshire, UK. natfot@yahoo.gr
Anastasia
A
Fotiadou
Andrew
A
Wojcik
Antony
A
Shaju
D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage; D001175:Arthrography / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D021801:Zygapophyseal Joint
D000779:Anesthetics, Local; D002045:Bupivacaine