Sonoanatomic indices of lumbar facet joints in patients with facetogenic back pain in comparison to healthy subjects.
BACKGROUND
Nowadays, ultrasound is increasingly used with a great accuracy in performing nerve blocks for facet joint disease.


OBJECTIVE
To measure sonoanatomic characteristics for the facet joints of lumbar vertebras in patients with facetogenic pain and healthy volunteers.


METHODS
Cross-sectional, observational study.


METHODS
University-affiliated Specialty Clinic for Pain Management.


METHODS
Twenty patients with facet joint disease (FJD) and 40 healthy volunteers (HVGs) were matched for age and sex, height, and weight. Patients with FJD were referred with complaints of pain in the left lumbar facet joints that twice responded favorably to ultrasound guided medial branch blocks.


METHODS
Medial branch blocks.


METHODS
The interfacet joint distance (IFJD) between the third, the fourth, and the fifth lumbar vertebras and their depth from the level of skin (DFS) were measured bilaterally, using a high-resolution ultrasound in both groups.


RESULTS
Thirty-one men and 29 women with average age of 41.5±9.5 years were enrolled. The IFJD for L3-L4 was 31.5±4.0 mm on the left side and 31.8±4.0 mm on the right side. The IFJD for L4-L5 was 31.3±4.4 mm on the left side and 31.5±4.0 mm on the right side. The IFJD was uniformly 2.2 mm shorter in the FJD group than those in the HVG group (P=.021). The measurements of DFS increased in lower vertebras (L3<L4<L5), bilaterally. With an exception of the left facet joints of L4 (P=.016), DFS measurements were similar in FJD and HVG groups.


CONCLUSIONS
The diagnosis of facet joint disease was merely clinical and the total number of the patients was relatively small.


CONCLUSIONS
Interfacet distances of the lumbar vertebras are smaller in patients suffering from degenerative FJD compared with HVGs. Degenerative changes of intervertebral discs and partial reduction of space between 2 adjacent vertebras may contribute to this observation.
Pain Research Center, Iran University of Medical Sciences, Tehran, Iran. Electronic address: poupak_rah@hotmail.com.
Poupak
P
Rahimzadeh
Endometriosis and Gynecologic Disorders Center, Iran University of Medical Sciences, Tehran, Iran. Electronic address: hrfaiz@hotmail.com.
Hamid Reza
HR
Faiz
Hormozgan University of Medical Sciences, Hormozgan, Iran. Electronic address: alireza.baghaee@gmail.com.
Ali Reza
AR
Baghaee
University at Buffalo, Buffalo, NY 14214, USA. Electronic address: nnader@buffalo.edu.
Nader D
ND
Nader
D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D012737:Sex Factors; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D014463:Ultrasonography / Q000379:methods; D021801:Zygapophyseal Joint / Q000000981:diagnostic imaging / Q000473:pathology*
Facet joint disease; Low back pain; Sonoanatomic indices; Ultrasonography