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Spinal Injections for Low Back Pain: Evidence-Based Treatment

  • John A. Carrino
  • Nikolai Bogduk
Reference work entry
Part of the Evidence-Based Imaging book series (Evidence-Based Imag.)

Abstract

Low back pain is a distinctly different condition from lumbar radicular pain (sometimes called “sciatica”). Radicular pain is lancinating pain that travels into the lower limb along a narrow band [1]. It is caused by disc herniation, foraminal stenosis, lateral recess stenosis, or other space-occupying lesions in the vertebral canal that compromise lumbosacral nerve roots. In contrast, low back is dull, aching pain that is centered on the lumbar, or lumbosacral, spine but may radiate into the buttocks or proximal thigh; it can radiate beyond the knee but not typically so. Its causes are elusive and difficult to determine.

Keywords

Oswestry Disability Index Moderate Evidence Spinal Injection Medial Branch Epidural Steroid Injection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Merskey H, Bogduk N, editors. Classification of chronic pain. Descriptions of chronic pain syndromes and definition of pain terms. 2nd ed. Seattle: IASP Press; 1994.Google Scholar
  2. 2.
    Acute low back problems in adults: assessment and treatment. Agency for Health Care Policy and Research. Clin Pract Guidel Quick Ref Guide Clin. 1994;(14):iii–iv, 1–25. PubMed PMID: 7987418.Google Scholar
  3. 3.
    Linton SJ. J Occup Rehabil. 2001;11:53–66.PubMedCrossRefGoogle Scholar
  4. 4.
    Moneta GB, Videman T, Kaivanto K, Aprill C, Spivey M, Vanharanta H, Sachs BL, Guyer RD, Hochschuler SH, Raschbaum RF, Mooney V. Spine. 1994;17:1968–74.CrossRefGoogle Scholar
  5. 5.
    McNally DS, Shackleford IM, Goodship AE, Mulholland RC. Spine. 1996;21:2500–87.CrossRefGoogle Scholar
  6. 6.
    Adams MA, McNally DS, Wagstaff J, Goodship AE. Eur Spine J. 1993;1:214–21.PubMedCrossRefGoogle Scholar
  7. 7.
    Holm S, Kaigle-Holm A, Ekstrom L, Karladani A, Hansson T. J Spinal Disord Tech. 2004;17:64–71.PubMedCrossRefGoogle Scholar
  8. 8.
    Cinotti G, Della Rocca C, Romeo S, Vittur F, Toffanin R, Trasimeni G. Spine. 2005;30:174–80.PubMedCrossRefGoogle Scholar
  9. 9.
    Haschtmann D, Stoyanov JV, Gédet P, Ferguson SJ. Eur Spin J. 2008;17:289–99.CrossRefGoogle Scholar
  10. 10.
    Rubin DI. Neurol Clin. 2007;25(2):353–71.PubMedCrossRefGoogle Scholar
  11. 11.
    Freburger JK, Holmes GM, Agans RP, Jackman AM, Darter JD, Wallace AS, Castel LD, Kalsbeek WD, Carey TS. Arch Intern Med. 2009;169(3):251–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Atkinson JH. J Rheumatol. 2004;31:2323–5.PubMedGoogle Scholar
  13. 13.
    Low back pain fact sheet. 2003. http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm#157903102. Accessed 25 Aug 2011.
  14. 14.
    Schwarzer AC, Aprill CN, Derby R, et al. Spine. 1995;20:1878–83.PubMedCrossRefGoogle Scholar
  15. 15.
    van Kleef M, Vanelderen P, Cohen SP, Lataster A, Van Zundert J, Mekhail N. Pain originating from the lumbar facet joints. Pain Pract. 2010;10(5):459–69.PubMedCrossRefGoogle Scholar
  16. 16.
    Schwarzer AC, Aprill CN, Bogduk N. Spine. 1995;20:31–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Maigne JY, Aivaliklis A, Pfefer F. Spine. 1996;21:1889–92.PubMedCrossRefGoogle Scholar
  18. 18.
    Dillon CF, Hirsch R. Am J Med Sci. 2011;341(4):281–3. Review. PubMed PMID: 21358307.PubMedCrossRefGoogle Scholar
  19. 19.
    Katz JN. J Bone Joint Surg Am. 2006;88(Suppl 2):21–4. Review. PubMed PMID: 16595438.PubMedCrossRefGoogle Scholar
  20. 20.
    Carrino JA, Morrison WB, Parker L, Schweitzer ME, Levin DC, Sunshine JH. Radiology. 2002;225(3):723–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Bigos S, Bowyer O, Braen G, et al. Acute low back problems in adults, Clinical Practice Guideline 1994, no.14. AHCPR Publication No. 95–0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, US, Department of Health; 1994.Google Scholar
  22. 22.
    van Tulder MW, Koes BW, Bouter LM. Spine (Phila Pa 1976). 1997;22(18):2128–56. Review.CrossRefGoogle Scholar
  23. 23.
    Nelemans PJ, de Bie RA, de Vet HC, Sturmans F. Spine (Phila Pa 1976). 2001;26(5):501–15. Review.CrossRefGoogle Scholar
  24. 24.
    Koes BW, Scholten RJPM, Mens JMA, Bouter LM. Pain Digest. 1999;9:241–7.Google Scholar
  25. 25.
    Watts RW, Silagy CA. Anaesth Intensive Care. 1995;23(5):564–9.PubMedGoogle Scholar
  26. 26.
    Khot A, Bowditch M, Powell J, et al. Spine. 2004;29:833–6.PubMedCrossRefGoogle Scholar
  27. 27.
    Simmons JW, McMillin JN, Emery SF, et al. Spine. 1992;17:S172–5.PubMedCrossRefGoogle Scholar
  28. 28.
    Buttermann GR. Spine J. 2004;4(5):495–505.PubMedCrossRefGoogle Scholar
  29. 29.
    Cohen SP, Wenzell D, Hurley RW, et al. Anesthesiology. 2007;107:99–105.PubMedCrossRefGoogle Scholar
  30. 30.
    Peng B, Pang X, Wu Y, Zhao C, Song X. Pain. 2010;149(1):124–9. Epub 2010 Feb 18.PubMedCrossRefGoogle Scholar
  31. 31.
    Klein RG, Eek BC, O’Neill CW, et al. Spine J. 2003;3:220–6.PubMedCrossRefGoogle Scholar
  32. 32.
    Oh WS, Shim JC. Clin J Pain. 2004;20:55–60.PubMedCrossRefGoogle Scholar
  33. 33.
    Barendse GA, van den Berg SG, Kessels AH, et al. Spine. 2001;26:287–92.PubMedCrossRefGoogle Scholar
  34. 34.
    Bogduk N, Karasek M. Spine J. 2002;2:343–50.PubMedCrossRefGoogle Scholar
  35. 35.
    Pauza KJ, Howell S, Dreyfuss P, Peloza JH, Dawson K, Bogduk N. Spine J. 2004;4:27–35.PubMedCrossRefGoogle Scholar
  36. 36.
    Freeman BJ, Fraser RD, Cain CM, et al. Spine. 2005;30:2369–77. discussion 2378.PubMedCrossRefGoogle Scholar
  37. 37.
    Karasek M, Bogduk N. Tech Reg Anesth Pain Manage. 2001;5:130–5.CrossRefGoogle Scholar
  38. 38.
    Lilius G, Laasonen EM, Myllynen P, Harilainen A, Salo L. Rev Chir Orthop Reparatrice Appar Mot. 1989;75:493–500.PubMedGoogle Scholar
  39. 39.
    Carette S, Marcoux S, Truchon R, et al. N Engl J Med. 1991;325:1002–7.PubMedCrossRefGoogle Scholar
  40. 40.
    Holder LE, Machin JL, Asdourian PL, Links JM, Sexton CC. J Nucl Med. 1995;36:37–44.PubMedGoogle Scholar
  41. 41.
    Dolan AL, Ryan PJ, Arden NK, et al. Br J Rheumatol. 1996;35:1269–73.PubMedCrossRefGoogle Scholar
  42. 42.
    Pneumaticos SG, Chatziioannou SN, Hipp JA, Moore WH, Esses SI. Radiology. 2006;238:693–8.PubMedCrossRefGoogle Scholar
  43. 43.
    Fuchs S, Erbe T, Fischer HL, Tibesku CO. J Vasc Interv Radiol. 2005;16(11):1493–8.PubMedCrossRefGoogle Scholar
  44. 44.
    Bogduk N, Dreyfuss P, Govind J. A narrative review of lumbar medial branch neurotomy for the treatment of back pain. Pain Med. 2009;10(6):1035–45.PubMedCrossRefGoogle Scholar
  45. 45.
    Gofeld M, Jitendra J, Faclier G. Pain Physician. 2007;10:291–300.PubMedGoogle Scholar
  46. 46.
    Van Kleef M, Barendse GA, Kessels F, Voets HM, Weber WE, De Lange S. Spine. 1999;24:1937–42.PubMedCrossRefGoogle Scholar
  47. 47.
    Nath S, Nath CA, Pettersson K. Spine. 2008;33(12):1291–7. discussion 1298.PubMedCrossRefGoogle Scholar
  48. 48.
    Tekin I, Mirzai H, Ok G, Erbuyun K, Vatansever D. Clin J Pain. 2007;23:524–9.PubMedCrossRefGoogle Scholar
  49. 49.
    Kroll HR, Kim D, Danic MJ, Sankey SS, Gariwala M, Brown M. J Clin Anesth. 2008;20:534–7.PubMedCrossRefGoogle Scholar
  50. 50.
    Schofferman J, Kine G. Spine. 2004;29:2471–3.PubMedCrossRefGoogle Scholar
  51. 51.
    Son JH, Kim SD, Kim SH, Lim DJ, Park JY. J Korean Neurosurg Soc. 2010;48(3):240–3.PubMedCrossRefPubMedCentralGoogle Scholar
  52. 52.
    Gallagher J, Vadi PLP, Wesley JR. Pain Clinic. 1994;7:193–8.Google Scholar
  53. 53.
    Leclaire R, Fortin L, Lambert R, Bergeron YM, Rossignol M. Spine (Phila Pa 1976). 2001;26(13):1411–6. Discussion 1417.CrossRefGoogle Scholar
  54. 54.
    van Wijk RM, Geurts JW, Wynne HJ, Hammink E, Buskens E, Lousberg R, Knape JT, Groen GJ. Clin J Pain. 2005;21(4):335–44. Erratum in: Clin J Pain. 2005;21(5):462.PubMedCrossRefGoogle Scholar
  55. 55.
    Chakraverty R, Dias R. Acupunct Med. 2004;22:207–13.PubMedCrossRefGoogle Scholar
  56. 56.
    Dussault RG, Kaplan PA, Anderson MW. Radiology. 2000;214:273–7.PubMedCrossRefGoogle Scholar
  57. 57.
    Hawkins J, Schofferman J. Pain Med. 2009;10:850–3.PubMedCrossRefGoogle Scholar
  58. 58.
    Murakami E, Tanaka Y, Aizawa T, Ishizuka M, Kokubun S. J Orthop Sci. 2007;12:274–80.PubMedCrossRefGoogle Scholar
  59. 59.
    Pulisetti D, Ebraheim NA. J Spinal Disord. 1999;12:310–2.PubMedCrossRefGoogle Scholar
  60. 60.
    Slipman CW, Lipetz JS, Plastaras CT, Jackson HB, Vresilovic EJ, Lenrow DA, Braverman DL. Am J Phys Med Rehabil. 2001;80:425–32.PubMedCrossRefGoogle Scholar
  61. 61.
    Liliang P, Lu K, Weng H, Liang CL, Tsai YD, Chen HJ. Spine. 2009;34:896–900.PubMedCrossRefGoogle Scholar
  62. 62.
    Luukkainen RK, Wennerstrand PV, Kautiainen HH, Sanila MT, Asikainen EL. Clin Exp Rheumatol. 2002;20:52–4.PubMedGoogle Scholar
  63. 63.
    Cui Y, Xiao Z, Shuxia W, Zhenjun Z, Hengguo Z, Liangyi F, Weicheng G, Li L, Guangfeng Z, Yunzhen S, Guangf D. Scand J Rheumatol. 2010;39:229–32.PubMedCrossRefGoogle Scholar
  64. 64.
    Gunaydin I, Pereira PL, Daikeler T, Mohren M, Trubenbach J, Schick F, Kanz L, Kotter I. J Rheumatol. 2000;27:424–8.PubMedGoogle Scholar
  65. 65.
    Hanly JG, Mitchell M, MacMillan L, Mosher D, Sutton E. J Rheumatol. 2000;27:719–22.PubMedGoogle Scholar
  66. 66.
    Karabacakoglu A, Karakose S, Ozerbil OM, Odev K. Acta Radiol. 2002;43:425–7.PubMedCrossRefGoogle Scholar
  67. 67.
    Maugars Y, Mathis C, Vilon P, Prost A. Arthritis Rheum. 1992;35:564–8.PubMedCrossRefGoogle Scholar
  68. 68.
    Ojala R, Klemola R, Karppinen J, Sequeiros RB, Tervonen O. Eur J Radiol. 2001;40:236–9.PubMedCrossRefGoogle Scholar
  69. 69.
    Pereira PL, Gunaydin I, Duda SH, Trubenbach J, Remy CT, Kotter I, Kastler B, Claussen CD. J Radiol. 2000;81:223–6.PubMedGoogle Scholar
  70. 70.
    Pereira PL, Gunaydin I, Trubenbach J, Dammann F, Remy CT, Kotter I, Schick F, Koenig CW, Claussen CD. Am J Roentgenol. 2000;175:265–6.CrossRefGoogle Scholar
  71. 71.
    Sadreddini S, Noshad H, Molaeefard M, Ardalan MR, Ghojazadeh M, Shakouri SK. Presse Med. 2009;38:710–6.PubMedCrossRefGoogle Scholar
  72. 72.
    Maugars Y, Mathis C, Berthelot JM, Charlier C, Prost A. Br J Rheumatol. 1996;35:767–70.PubMedCrossRefGoogle Scholar
  73. 73.
    Luukkainen R, Nissila M, Asikainen E, Sanila M, Lehtinen K, Alanaatu A, Kautianen H. Clin Exp Rheumatol. 1999;17:88–90.PubMedGoogle Scholar
  74. 74.
    Serrao JM, Marks RL, Morley SJ, Goodchild CS. Pain. 1992;48(1):5–12.PubMedCrossRefGoogle Scholar
  75. 75.
    Manchikanti L, Cash KA, McManus CD, Pampati V, Benyamin RM. Pain Physician. 2010;13:E279–92.PubMedGoogle Scholar
  76. 76.
    Manchikanti L, Cash KA, McManus CD, Pampati V, Smith HS. Pain Physician. 2008;11:785–800.PubMedGoogle Scholar
  77. 77.
    White AH, Derby R, Wynne G. Spine. 1980;5:78–86.PubMedCrossRefGoogle Scholar
  78. 78.
    El-Khoury G, Ehara S, Weinstein JW, Montgomery WJ, Kathol MH. Radiology. 1988;168:554–7.PubMedGoogle Scholar
  79. 79.
    Stitz MY, Sommer HM. Spine. 1999;24:1371–6.PubMedCrossRefGoogle Scholar
  80. 80.
    Price CM, Rogers PD, Prosser ASJ, Arden NK. Ann Rheum Dis. 2000;59:879–82.PubMedCrossRefPubMedCentralGoogle Scholar
  81. 81.
    Bartynski WS, Grahovac SZ, Rothfus WE. Am J Neuroradiol. 2005;26:502–5.PubMedGoogle Scholar
  82. 82.
    Manchikanti L, Cash KA, Pampati V, McManus CD, Damron KS. Pain Physician. 2004;7:81–92.PubMedGoogle Scholar
  83. 83.
    Mehta M, Salmon N. Extradural block, confirmation of the injection site by X-ray monitoring. Anaesthesia. 1985;40:1009–12.PubMedCrossRefGoogle Scholar
  84. 84.
    Sullivan WJ, Willick SE, Chira-Adisai W, et al. Spine (Phila Pa 1976). 2000;25:481–6.CrossRefGoogle Scholar
  85. 85.
    Furman MB, O’Brien EM, Zgleszewski TM. Spine (Phila Pa 1976). 2000;25:2628–32.CrossRefGoogle Scholar
  86. 86.
    Manchikanti L, Cash KA, Pampati V, Damron KS, McManus CD. Pain Physician. 2004;7:217–23.PubMedGoogle Scholar
  87. 87.
    Furman MB, Giovanniello MT, O’Brien EM. Spine (Phila Pa 1976). 2003;28:21–5.CrossRefGoogle Scholar
  88. 88.
    Goodman BS, Lincoln CE, Deshpande KK, Poczatek RB, Lander PH, Devivo MJ. Pain Physician. 2005;8:263–6.PubMedGoogle Scholar
  89. 89.
    Willems PC, Jacobs W, Duinkerke ES, De Kleuver M. J Spinal Disord Tech. 2004;17(3):243–7. Review.PubMedCrossRefGoogle Scholar
  90. 90.
    Kennedy DJ, Dreyfuss P, Aprill CN, Bogduk N. Pain Med. 2009;10(8):1389–94.PubMedCrossRefGoogle Scholar
  91. 91.
    Lyders EM, Morris PPAJNR. Am J Neuroradiol. 2009;30(9):1691–3.PubMedCrossRefGoogle Scholar
  92. 92.
    Glaser SE, Falco F. Pain Physician. 2005;8(3):309–14.PubMedGoogle Scholar
  93. 93.
    Houten JK, Errico TJ. Spine J. 2002;2(1):70–5.PubMedCrossRefGoogle Scholar
  94. 94.
    Thefenne L, Dubecq C, Zing E, Rogez D, Soula M, Escobar E, Defuentes G, Lapeyre E, Berets O. Ann Phys Rehabil Med. 2010;53(9):575–83.PubMedCrossRefGoogle Scholar
  95. 95.
    Bogduk N, editor. Practice guidelines. Spinal diagnostic and treatment procedures. San Francisco: International Spine Intervention Society; 2004.Google Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Newcastle Bone and Joint InstituteRoyal Newcastle Center, University of NewcastleNewcastleAustralia

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