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Facets of facet joint interventions

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Abstract

Facet joint (FJ) disease is a common cause of axial low back pain with many minimally invasive image-guided treatment options. This article discusses fluoroscopic and CT-guided intraarticular FJ injections, medial branch (MB) radiofrequency ablation (RFA), and lumbar facet synovial cyst (LFSC) aspiration, rupture, or fenestration. Additionally, the article will highlight medial branch blocks (MBBs) utilized to diagnose facet-mediated pain and to predict outcomes to RFA.

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Author information

Authors and Affiliations

  1. Department of Radiology, Duke University Health System, 2301 Erwin Road, Box 3808, Durham, NC, 27110, USA

    Nicholas Said, Timothy J. Amrhein & Peter G. Kranz

  2. Department of Orthopaedic Surgery, Emory University, Atlanta, GA, USA

    Anand B. Joshi

  3. Department of Radiology and Medical Imaging, University of Virginia, 1215 Lee St, PO Box 800170, Charlottesville, VA, 22908, USA

    Nicholas C. Nacey N

Authors
  1. Nicholas Said
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  2. Timothy J. Amrhein
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  3. Anand B. Joshi
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  4. Nicholas C. Nacey N
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  5. Peter G. Kranz
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Correspondence to Nicholas Said.

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Key points

• Fluoroscopic and CT image-guided intraarticular injections and radiofrequency ablation are valuable techniques for treating back pain arising from facet joints.

• Fluoroscopic and CT image-guided medial branch blocks have been validated for diagnosing pain arising from facet joints and can predict response to subsequent facet joint radiofrequency ablation.

• Fluoroscopic and CT image-guided techniques offer a nonoperative treatment option for patients with symptomatic intraspinal facet synovial cysts that can cause back pain and radiculopathy.

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Said, N., Amrhein, T.J., Joshi, A.B. et al. Facets of facet joint interventions. Skeletal Radiol 52, 1873–1886 (2023). https://doi.org/10.1007/s00256-022-04184-5

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  • DOI: https://doi.org/10.1007/s00256-022-04184-5

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