title: The impact of sagittal balance on low back pain in patients treated with zygoapophysial facet joint injection.
abstract: BACKGROUND
  Aim of the study was to evaluate the effectiveness of facet joints injections in lumbar facet syndrome correlating clinical results to the sagittal contour of the spine.
  
  
  METHODS
  Facet joints degree degeneration was evaluated using MRI according to Fujiwara classification. Sagittal contour of the spine was evaluated according to Roussouly classification. The clinical results were evaluated with visual analog scale (VAS) at regular intervals.
  
  
  RESULTS
  Twenty-eight (70 %) of the 40 patients had clinical symptoms improvement, 12 (30 %) showed no benefit. There was a statistical significant correlation between postoperative VAS value improvement and Roussouly spine type 1 and 3 (p = 0.003). The benefit was more durable in patients with grade 2 or 3 degeneration.
  
  
  CONCLUSIONS
  Facet joints injections have a more effective diagnostic than therapeutic value. The procedure could, however, give a temporary pain relief in cases with an overload of the facet joints due to lumbar hyperlordosis.
authors.affiliation: Division of Spinal Surgery, Department of Orthopaedics and Traumatology, Catholic University Hospital, Largo A. Gemelli 8, 00168, Rome, Italy, proiettil@yahoo.it.
authors.forename: L
authors.initials: L
authors.lastname: Proietti
authors.forename: G R
authors.initials: GR
authors.lastname: Schirò
authors.forename: S
authors.initials: S
authors.lastname: Sessa
authors.forename: L
authors.initials: L
authors.lastname: Scaramuzzo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007270:Injections, Intra-Articular; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D017116:Low Back Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D013131:Spine / Q000473:pathology*; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000627:therapeutic use; D021801:Zygapophyseal Joint
chemical_list: D000779:Anesthetics, Local; D004338:Drug Combinations; D005938:Glucocorticoids; D014222:Triamcinolone Acetonide; D002045:Bupivacaine