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Ralph J Mobbs, Kevin Phan, Greg Malham, Kevin Seex, Prashanth J Rao
Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF)...
December 2015: J Spine Surg
Alexander Bautista, Alisher Dadabayev, Ellen Rosenquist, Jianguo Cheng
We report 2 cases of successful treatment of neck and back pain with bipolar radiofrequency ablation (RFA) of the cervical and lumbar facet joints in patients with an automatic implantable cardioverter defibrillator (AICD).Two patients with complex cardiac histories and AICD devices were treated with bipolar RFA of the facet joints. One presented with axial neck pain and the other with axial back pain. The histories and physical examinations were consistent with facetogenic pain. Diagnostic medial branch block resulted in more than 70% pain relief lasting for several days, allowing patients to perform routine daily activities without significant pain...
March 2016: Pain Physician
Young Joo, Yong Chul Kim, Sang Chul Lee, Hye Young Kim, Keun Suk Park, Eun Joo Choi, Jee Youn Moon
BACKGROUND AND OBJECTIVES: Intravascular (IV) injection of local anesthetics is a potential cause of false-negative results after lumbar medial branch nerve blockade (L-MBB) performed to diagnose facetogenic back pain. The aim of the present study was to identify the relationship between the needle type and the incidence of IV injection in patients undergoing L-MBB using fluoroscopy with digital subtraction imaging (DSI). METHODS: In this prospective randomized study, we compared the incidence of IV uptake of contrast medium using the Quincke needle and Whitacre needle under real-time DSI during L-MBB...
May 2016: Regional Anesthesia and Pain Medicine
Zachary A Smith, Saeed Khayatzadeh, Joshua Bakhsheshian, Michael Harvey, Robert M Havey, Leonard I Voronov, Muturi G Muriuki, Avinash G Patwardhan
PURPOSE: Patients with cervical spondylosis commonly present with neck pain, radiculopathy or myelopathy. As degenerative changes progress, multiple factors including disc height loss, thoracic kyphosis, and facetogenic changes can increase the risk of neural structure compression. This study investigated the impact of cervical deformity including forward head posture (FHP) and upper thoracic kyphosis, on the anatomy of the cervical neural foramen. METHODS: Postural changes of 13 human cervical spine specimens (Occiput-T1, age 50...
July 2016: European Spine Journal
Michael C Dahl, Andrew L Freeman
BACKGROUND CONTEXT: Although approximately 30% of chronic lumbar pain can be attributed to the facets, limited surgical options exist for patients. Interpositional facet arthroplasty (IFA) is a novel treatment for lumbar facetogenic pain designed to provide patients who gain insufficient relief from medical interventional treatment options with long-term relief, filling a void in the facet pain treatment continuum. PURPOSE: This study aimed to quantify the effect of IFA on segmental range of motion (ROM) compared with the intact state, and to observe device position and condition after 10,000 cycles of worst-case loading...
April 2016: Spine Journal: Official Journal of the North American Spine Society
Pietro Martino Schianchi
INTRODUCTION: Facet joint pain affects 5% to 15% of the population with low back pain and the prevalence increases with age due to progression of arthritis. While conservative treatments are often unsuccessful, the scientific evidence on minimally invasive therapies such as intra-articular steroid infiltration and continuous and pulsed radiofrequency (PRF) of the medial branches is contradictory. Since PRF has recently been reported to successfully treat joint pain, a new application of this method is proposed for facetogenic lumbar pain via an intra-articular subcapsular approach...
February 2015: Anesthesiology and Pain Medicine
Zhen-Zhou Li, Shu-Xun Hou, Wei-Lin Shang, Ke-Ran Song, Wen-Wen Wu
OBJECTIVE: To study the effectiveness of surgical dorsal endoscopic rhizotomy for the treatment of facetogenic chronic low back pain. METHODS: From April 2011 to November 2011, 58 patients who were diagnosed with lumbar facetogenic chronic low back pain (CLBP) and thereafter experienced >80% reliefs of pain with two comparative lumbar medial branch blocks were recruited in the study. Of those 58 patients, 45 cases (the operation group) received dorsal endoscopic rhizotomy, and the remaining 13 cases (the conservative group) received conservative treatment...
November 2014: Clinical Neurology and Neurosurgery
Hosam E Matar, Shaunak Navalkissoor, Marko Berovic, Rohit Shetty, Nicholas Garlick, Adrian T H Casey, Ann-Marie Quigley
PURPOSE: The purpose of this study was to assess the value of SPECT/CT imaging in patients with chronic spinal pain. METHODS: This was a retrospective consecutive study. Patients with chronic neck or back pain from outpatient spinal clinics with clinical features raising the possibility of a facetogenic pain generator and non-conclusive MRI/CT findings were included. Imaging was performed on a dual-headed, hybrid SPECT/CT γ-camera with a low-dose CT transmission scan acquired after the SPECT study...
May 2013: International Orthopaedics
Steven P Cohen, Julie H Y Huang, Chad Brummett
Facetogenic pain, also known as zygapophysial joint pain, is a frequent cause of mechanical spine pain. Diagnostic blocks (for example, medial branch blocks [MBBs]) are the only reliable approach to identify facet joints as the source of neck or back pain. In the absence of a reference standard, MBBs actually serve more of a prognostic than diagnostic role, enabling the selection of patients who might respond to radiofrequency denervation treatment--the standard treatment for facet joint pain. Using double blocks reduces the false-positive rate of MBBs, but will invariably reduce the overall treatment success rate...
February 2013: Nature Reviews. Rheumatology
Steven Paul Cohen, Scott A Strassels, Connie Kurihara, Scott R Griffith, Brandon Goff, Kevin Guthmiller, Hieu T Hoang, Benny Morlando, Conner Nguyen
OBJECTIVES: Diagnostic medial branch blocks (MBB) are considered the reference standard for diagnosing facetogenic pain and selecting patients for radiofrequency (RF) denervation. Great controversy exists regarding the ideal cutoff for designating a block as positive. The purpose of this study is to determine the optimal pain relief threshold for selecting patients for RF denervation after diagnostic MBB. METHODS: In this multicenter, prospective correlational study, 61 consecutive patients undergoing lumbar facet RF denervation after experiencing significant pain relief after MBB were enrolled...
May 2013: Clinical Journal of Pain
Jan Van Zundert, Pascal Vanelderen, Alfons Kessels, Maarten van Kleef
Pain originating from the lumbar facet joints is estimated to represent about 15% of all low back pain complaints. The diagnostic block is considered to be a valuable tool for confirming facetogenic pain. It was demonstrated that a block of the ramus medialis of the ramus dorsalis is preferred over an intra-articular injection. The outcome of the consequent radiofrequency treatment is not different in patients reporting over 80% pain relief after the diagnostic block than in those who have between 50% and 79% pain relief...
February 2012: Current Pain and Headache Reports
Michael J DePalma, Jessica M Ketchum, Thomas Saullo
OBJECTIVE: The objective of this study was to estimate the prevalence, mean age, and association of prevalence and age of lumbar internal disc disruption (IDD), facet joint pain (FJP), sacroiliac joint pain (SIJP), spinal and pelvic insufficiency fractures, interspinous ligament injury/Baastrup's Disease, and soft tissue irritation by fusion hardware. DESIGN: The study's design was a retrospective chart review. SETTING: The study was set in an academic spine center...
February 2011: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Maarten van Kleef, Pascal Vanelderen, Steven P Cohen, Arno Lataster, Jan Van Zundert, Nagy Mekhail
Although the existence of a "facet syndrome" had long been questioned, it is now generally accepted as a clinical entity. Depending on the diagnostic criteria, the zygapophysial joints account for between 5% and 15% of cases of chronic, axial low back pain. Most commonly, facetogenic pain is the result of repetitive stress and/or cumulative low-level trauma, leading to inflammation and stretching of the joint capsule. The most frequent complaint is axial low back pain with referred pain perceived in the flank, hip, and thigh...
September 2010: Pain Practice: the Official Journal of World Institute of Pain
Brian Rambaransingh, Gordon Stanford, Robert Burnham
OBJECTIVE: To assess the effectiveness of repeated radiofrequency neurotomy (RFN) on pain, disability, and treatment effect duration. PATIENTS: One hundred-four patients who underwent repeat RFN for chronic neck or back pain were prospectively followed using a Pain Disability Questionnaire-Spine (PDQ-S). Complete data sets were available for 73, 73, and 36 patients for the 1st, 2nd, and 3rd RFN, respectively. RESULTS: Pain intensity, pain frequency, and patient-specific disability measures were significantly improved post-initial, second, and third RFN...
September 2010: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Steven P Cohen, Kayode A Williams, Connie Kurihara, Conner Nguyen, Cynthia Shields, Peter Kim, Scott R Griffith, Thomas M Larkin, Matthew Crooks, Necia Williams, Benny Morlando, Scott A Strassels
BACKGROUND: Among patients presenting with axial low back pain, facet arthropathy accounts for approximately 10-15% of cases. Facet interventions are the second most frequently performed procedures in pain clinics across the United States. Currently, there are no uniformly accepted criteria regarding how best to select patients for radiofrequency denervation. METHODS: A randomized, multicenter study was performed in 151 subjects with suspected lumbar facetogenic pain comparing three treatment paradigms...
August 2010: Anesthesiology
Sherief Gamie, Tarek El-Maghraby
BACKGROUND: Bone scintigraphy including Single Photon Emission Computed Tomography (SPECT) is known for its role in the diagnosis of low back pain disorders. Positron Emission Tomography (PET) with (18)F (Flouride-18) as a tracer can be used to carry out bone scans with improved image quality. With the addition of CT, simultaneous PET/CT fused images provide more accurate anatomical details. The objectives of this work are to assess the use of (18)F-PET/CT in patients with back pain and suspected facetogenic pain, and to find the frequency of facet arthropathy versus disc disease abnormalities...
2008: Nuclear Medicine Review. Central & Eastern Europe
Gordon Li, Chirag Patil, John R Adler, Shivanand P Lad, Scott G Soltys, Iris C Gibbs, Laurie Tupper, Maxwell Boakye
OBJECT: By targeting the medial branches of the dorsal rami, radiofrequency ablation and facet joint injections can provide temporary amelioration of facet joint-producing (or facetogenic) back pain. The authors used CyberKnife radiosurgery to denervate affected facet joints with the goal of obtaining a less invasive yet more thorough and durable antinociceptive rhizotomy. METHODS: Patients with refractory low-back pain, in whom symptoms are temporarily resolved by facet joint injections, were eligible...
2007: Neurosurgical Focus
Keun-young Anthony Kim, Michael Y Wang
OBJECTIVE: A major barrier to understanding facetogenic low back pain has been the lack of radiographic diagnostic criteria. This study investigates the correlation between radiographic findings on magnetic resonance imaging (MRI) scans and single photon emission computed tomographic (SPECT) scans in patients clinically found to have facetogenic axial back pain. METHODS: Thirty-one patients with severe axial back pain underwent lumbar MRI and SPECT scans. Two hundred thirty facets were identified and were graded from 1 to 4 using synovial area, size, cartilaginous discontiguity, osteophytic overgrowth, and joint space obliteration...
July 2006: Neurosurgery
J S Brault, J Smith, B L Currier
STUDY DESIGN: Case report of surgically treated mechanical low back pain from the facet joint contralateral to a unilateral anomalous lumbosacral articulation (Bertolotti's syndrome). OBJECTIVES: To describe the clinical presentation, diagnostic evaluation, and management of facet-related low back pain in a 17-year-old cheerleader and its successful surgical treatment with resection of a contralateral anomalous articulation. SUMMARY OF BACKGROUND DATA: Lumbosacral transitional vertebrae are common in the general population...
January 15, 2001: Spine
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