title: A comparison of intraarticular lumbar facet joint steroid injections and lumbar facet joint radiofrequency denervation in the treatment of low back pain: a randomized, controlled, double-blind trial.
abstract: BACKGROUND
  Lumbar facet joint degeneration is a source of chronic low back pain, with an incidence of 15% to 45% among patients with low back pain. Various therapeutic techniques in the treatment of facet-related pain have been described in the literature, including intraarticular lumbar facet joint steroid injections and radiofrequency denervation. In this study, we compared the effectiveness of intraarticular facet joint steroid injections and radiofrequency denervation.
  
  
  METHODS
  Our randomized, double-blind, controlled study included patients who received intraarticular steroid infiltrations in the lumbar facet joints (L3/L4-L5/S1) and patients who underwent radiofrequency denervation of L3/L4-L5/S1 segments. The inclusion criteria were based first on magnetic resonance imaging findings showing hypertrophy of the facet joints L3/L4-L5/S1 and a positive response to an intraarticular test infiltration of the facet joints L3/L4-L5/S1 with local anesthetics. The primary end point was the Roland-Morris Questionnaire. Secondary end points were the visual analog scale and the Oswestry Disability Index. All outcome assessments were performed at baseline and at 6 months.
  
  
  RESULTS
  Fifty-six patients were randomized; 24 of 29 patients in the steroid injection group and 26 of 27 patients in the denervation group completed the 6-month follow-up. Pain relief and functional improvement were observed in both groups. There were no significant differences between the 2 groups for the primary end point (95% confidence interval [CI], -3 to 4) and for both secondary end points (95% CI for visual analog scale, -2 to 1; 95% CI for Oswestry Disability Index, -18 to 0).
  
  
  CONCLUSIONS
  Intraarticular steroid infiltration or radiofrequency denervation appear to be a managing option for chronic function-limiting low back pain of facet origin with favorable short- and midterm results in terms of pain relief and function improvement, but improvements were similar in both groups.
authors: Department of Orthopedics, University Hospital Goettingen, Robert-Koch-Straße 40, D-37075 Göttingen, Germany. stefan.lakemeier@med.uni-goettingen.de
authors: Stefan
authors: S
authors: Lakemeier
authors: Marcel
authors: M
authors: Lind
authors: Wolfgang
authors: W
authors: Schultz
authors: Susanne
authors: S
authors: Fuchs-Winkelmann
authors: Nina
authors: N
authors: Timmesfeld
authors: Christian
authors: C
authors: Foelsch
authors: Christian D
authors: CD
authors: Peterlein
mesh_terms: D000328:Adult; D000368:Aged; D017763:Autonomic Denervation / Q000379:methods* / Q000592:standards; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D017116:Low Back Pain / Q000175:diagnosis / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D008875:Middle Aged; D061208:Pulsed Radiofrequency Treatment / Q000379:methods* / Q000592:standards; D013256:Steroids / Q000008:administration & dosage*; D016896:Treatment Outcome; D021801:Zygapophyseal Joint
chemical_list: D013256:Steroids