title: Controlled medial branch anesthetic block in the diagnosis of chronic lumbar facet joint pain: the value of a three-month follow-up.
abstract: OBJECTIVE
  To verify the incidence of facetary and low back pain after a controlled medial branch anesthetic block in a three-month follow-up and to verify the correlation between the positive results and the demographic variables.
  
  
  METHODS
  Patients with chronic lumbar pain underwent a sham blockade (with a saline injection) and then a controlled medial branch block. Their symptoms were evaluated before and after the sham injection and after the real controlled medial branch block; the symptoms were reevaluated after one day and one week, as well as after one, two and three months using the visual analog scale. We searched for an association between the positive results and the demographic characteristics of the patients.
  
  
  RESULTS
  A total of 104 controlled medial branch blocks were performed and 54 patients (52%) demonstrated >50% improvements in pain after the blockade. After three months, lumbar pain returned in only 18 individuals, with visual analogue scale scores >4. Therefore, these patients were diagnosed with chronic facet low back pain. The three-months of follow-up after the controlled medial branch block excluded 36 patients (67%) with false positive results. The results of the controlled medial branch block were not correlated to sex, age, pain duration or work disability but were correlated with patient age (p<0.05).
  
  
  CONCLUSIONS
  Patient diagnosis with a controlled medial branch block proved to be effective but was not associated with any demographic variables. A three-month follow-up is required to avoid a high number of false positives.
authors.affiliation: Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP), Spine Surgery Division, São Paulo, SP, Brazil.
authors.forename: Ivan Dias da
authors.initials: ID
authors.lastname: Rocha
authors.affiliation: Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP), Spine Surgery Division, São Paulo, SP, Brazil.
authors.forename: Alexandre Fogaça
authors.initials: AF
authors.lastname: Cristante
authors.affiliation: Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP), Spine Surgery Division, São Paulo, SP, Brazil.
authors.forename: Raphael Martus
authors.initials: RM
authors.lastname: Marcon
authors.affiliation: Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP), Spine Surgery Division, São Paulo, SP, Brazil.
authors.forename: Reginaldo Perilo
authors.initials: RP
authors.lastname: Oliveira
authors.affiliation: Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP), Spine Surgery Division, São Paulo, SP, Brazil.
authors.forename: Olavo Biraghi
authors.initials: OB
authors.lastname: Letaif
authors.affiliation: Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IOT-HCFMUSP), Spine Surgery Division, São Paulo, SP, Brazil.
authors.forename: Tarcisio Eloy Pessoa de
authors.initials: TE
authors.lastname: Barros Filho
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000779:Anesthetics, Local; D001938:Brazil; D002908:Chronic Disease; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008012:Lidocaine; D017116:Low Back Pain / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D011859:Radiography; D021801:Zygapophyseal Joint / Q000000981:diagnostic imaging*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine