Acta Neurochirurgica

, Volume 148, Issue 11, pp 1165–1172

Injection therapy of lumbar facet syndrome: a prospective study

  • T. L. Schulte
  • T. A. Pietilä
  • J. Heidenreich
  • M. Brock
  • R. Stendel
Clinical Article

DOI: 10.1007/s00701-006-0897-z

Cite this article as:
Schulte, T., Pietilä, T., Heidenreich, J. et al. Acta Neurochir (Wien) (2006) 148: 1165. doi:10.1007/s00701-006-0897-z

Summary

Background. Chronic low back pain remains a major health problem. Facet joint injection therapy is an easy to perform therapeutic option. However, few prospective studies use a standardized protocol to investigate injection therapy. The aim of our study was to evaluate quantity and duration of clinical improvement after this protocol, and to identify the best time for additional repetitive injection therapy.

Materials and Methods. Thirty-nine patients (21 men, 18 women; mean age 55.2 years [range, 29–87 years]) with lumbar facet syndrome were treated with injection using a standardized protocol (prednisolone acetate, lidocaine 1%, phenol 5%) under fluoroscopic control. Follow-up was based on a specially designed questionnaire. Analysis included MacNab criteria, visual analogue scale, and pain disability index.

Results. Reduction of pain was found up to 6 months after treatment. The outcome was assessed excellent or good by 62% (24 patients) of the patients after 1 month, by 41% (16 patients) after 3 months, and by 36% (14 patients) after 6 months. There was no influence of age, body mass index, or previous lumbar spinal surgery on improvement after treatment. There were no severe side effects. Short-lasting self limiting mild side effects were found in 26% (increased back pain, numbness, heartburn, headache, allergy).

Conclusion. Facet joint injection therapy using a standardized protocol is safe, effective, and easy to perform. The clinical effect is limited, and we recommend repetitive injection according to this protocol after 3 months.

Keywords: Facet joint injection; lumbar facet syndrome; low back pain; infiltration therapy. 

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • T. L. Schulte
    • 1
  • T. A. Pietilä
    • 2
  • J. Heidenreich
    • 3
  • M. Brock
    • 4
  • R. Stendel
    • 4
  1. 1.Department of OrthopaedicsUniversity Hospital MünsterMünsterGermany
  2. 2.Department of NeurosurgeryKlinikum IngolstadtIngolstadtGermany
  3. 3.Department of Radiology and Nuclear MedicineCharité – University Medicine BerlinBerlinGermany
  4. 4.Department of NeurosurgeryCharité – University Medicine BerlinBerlinGermany

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