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Ralph Mobbs, Ryan Campbell, Kevin Phan
To classify facet joint cysts (FJC) which will assist in identification of patient groups to best fit with a particular intervention. Sagittal T2 -weighted magnetic resonance images (MRI) of these patients are used to measure cyst size, while axial T2 -weighted MRI are used to determine the percentage of the vertebral canal occupied by the cyst. The degree of spondylolisthesis is also measured through standing X-rays or sagittal MRI. The proposed grading system is as follows. Grade I includes cysts that occupy less than 25% of the canal diameter that usually present with unilateral radiculopathy...
February 12, 2018: Orthopaedic Surgery
N W Jenkins, J F Talbott, V Shah, P Pandit, Y Seo, W P Dillon, S Majumdar
Our aim was to prospectively evaluate the relationship between low back pain-related disability and quantitative measures from [(18)F]-sodium fluoride ([(18)F]-NaF) MR imaging. Six patients with facetogenic low back pain underwent dynamic [(18)F]-NaF PET/MR imaging. PET metrics were correlated with clinical measures and MR imaging grading of lumbar facet arthropathy. A significant positive correlation was observed between maximum facet joint uptake rate and clinical disability (P < .05). These data suggest that dynamic [(18)F]-NaF PET may serve as a useful biomarker for facetogenic disability...
October 2017: AJNR. American Journal of Neuroradiology
Charles A Odonkor, Yian Chen, Peju Adekoya, Bryan J Marascalchi, Hira Chaudhry-Richter, Teresa Tang, Christopher Abruzzese, Berklee K Cohen, Steven P Cohen
BACKGROUND: Low back pain is the leading cause of years lost to disability with approximately 15%-25% of the chronic back pain population suffering from lumbar facet arthropathy. No large-scale study has sought to systematically identify inciting events for lumbar facet arthropathy. The aim of this study is to quantify the proportion of individuals with lumbar facetogenic pain who report a specific precipitating event(s) and to determine if there is a correlation between these events and treatment outcome...
January 2018: Anesthesia and Analgesia
Michael Sniderman
A 59-year-old patient presented to the chronic pain clinic with a 6-week history of worsening lumbar back pain, bilateral thigh pain, and unilateral radiculopathy. Magnetic resonance imaging revealed mild discogenic and facetogenic disease, but significant epidural venous plexus engorgement compressing the thecal sac. The patient reported previous treatment by a vascular surgeon for May-Thurner Syndrome, a type of inferior vena caval obstruction, yet had not experienced these specific complaints. A discussion with the radiologist confirmed worsening of the patient's May-Thurner Syndrome was the likely cause of the patient's symptoms...
November 15, 2017: A & A Case Reports
Varun Kumar Rimmalapudi, Sanjeev Kumar
Chronic back pain is often a result of coexisting pathologies; secondary causes of pain can become more apparent sources of pain once the primary pathology has been addressed. The objective of our study was to determine if there is an increase in diagnosis of Sacroiliac joint pain following a Lumbar Rhizotomy. A list of patients who underwent Lumbar Radiofrequency during a 6-month period in our clinic was generated. Records from subsequent clinic visits were reviewed to determine if a new diagnosis of SI joint pathology was made...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
Poupak Rahimzadeh, Hamid Reza Faiz, Ali Reza Baghaee, Nader D Nader
BACKGROUND: Nowadays, ultrasound is increasingly used with a great accuracy in performing nerve blocks for facet joint disease. OBJECTIVES: To measure sonoanatomic characteristics for the facet joints of lumbar vertebras in patients with facetogenic pain and healthy volunteers. STUDY DESIGN: Cross-sectional, observational study. SETTING: University-affiliated Specialty Clinic for Pain Management. PATIENTS: Twenty patients with facet joint disease (FJD) and 40 healthy volunteers (HVGs) were matched for age and sex, height, and weight...
February 2017: Journal of Clinical Anesthesia
Juan A Ramos
INTRODUCTION: Facet joint pain is a common source of non-radicular back pain worldwide. Non-surgical interventional modalities remain the mainstay in the treatment of facetogenic back pain and comprise the second most commonly performed interventional pain procedures in the USA. CASE: A 36 year-old man with chronic cervical pain secondary to C6-C7 facet arthrosis radiographically, underwent diagnostic local anesthetic bilateral facet joint injection under fluoroscopic guidance...
November 2016: Brazilian Journal of Anesthesiology
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: Journal of Spine Surgery (Hong Kong)
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
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