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Zygapophyseal Joints

Maarten van Eerd, Arno Lataster, Micha Sommer, Jacob Patijn, Maarten van Kleef
The cervical facet joints, also called the zygapophyseal joints, are a potential source of neck pain (cervical facet joint pain). The cervical facet joints are innervated by the cervical medial branches (CMBs) of the cervical segmental nerves. Cervical facet joint pain has been shown to respond to multisegmental radiofrequency denervation of the cervical medial branches. This procedure is performed under fluoroscopic guidance. Currently, three approaches are described and used. Those three techniques of radiofrequency treatment of the CMBs, classified on the base of the needle trajectory toward the anatomical planes, are as follows: the posterolateral technique, the posterior technique, and the lateral technique...
October 13, 2016: Pain Practice: the Official Journal of World Institute of Pain
Yashar Eshraghi, Vimal Desai, Calvin Cajigal Cajigal, Kutaiba Tabbaa
BACKGROUND: Lumbar synovial cysts can result from spondylosis of facet joints. These cysts can encroach on adjacent nerve roots, causing symptoms of radiculopathy. Currently the only definitive treatment for these symptoms is surgery, which may involve laminectomy or laminotomy, with or without spinal fusion. Surgery has been reported to successfully relieve radicular pain in 83.5% of patients by Zhenbo et al. Little information is available concerning the efficacy and outcome of percutaneous fluoroscopic synovial cyst rupture for treatment of facet joint synovial cysts...
September 2016: Pain Physician
David Arsanious, Emmanuel Gage, Jonathon Koning, Mazin Sarhan, Gassan Chaiban, Mohammed Almualim, Joseph Atallah
BACKGROUND: One of the potential side effects with radiofrequency ablation (RFA) includes painful cutaneous dysesthesias and increased pain due to neuritis or neurogenic inflammation. This pain may require the prescription of opioids or non-opioid analgesics to control post-procedural pain and discomfort. OBJECTIVES: The goal of this study is to compare post-procedural pain scores and post-procedural oral analgesic use in patients receiving continuous thermal radiofrequency ablation versus patients receiving pulsed dose radiofrequency immediately followed by continuous thermal radiofrequency ablation for zygopophaseal joint disease...
September 2016: Pain Physician
M Le Hanneur, C Vidal, C Mallet, K Mazda, B Ilharreborde
A 32-month-old boy presented with febrile limping that had developed over 6days, associated with right lumbosacral inflammatory swelling. Magnetic resonance imaging (MRI) showed joint effusion of the right L5-S1 zygapophyseal joint, complicated by destructive osteomyelitis of the L5 articular process and paraspinal abscess. Surgery was decided to evacuate the fluid accumulation and rule out differential diagnoses. The diagnosis of septic arthritis of the facet joint was confirmed intraoperatively; real-time quantitative PCR analysis identified Kingella kingae...
September 14, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Scott F Farrell, Peter G Osmotherly, Jon Cornwall, Peter Lau, Darren A Rivett
Study Design Case-control study. Background Cervical spine meniscoids are thought to contribute to neck pain and hypomobility in individuals with chronic whiplash-associated disorder (WAD); however, their morphology has not been studied in a clinical population. Objectives To investigate cervical spine meniscoid morphology in individuals with chronic WAD. Methods Twenty volunteers with chronic WAD (mean ± SD age, 39.3 ± 11.0 years; 10 female) and 20 age- and sex-matched controls (age, 39.1 ± 10.6 years) underwent cervical spine magnetic resonance imaging...
October 2016: Journal of Orthopaedic and Sports Physical Therapy
Keita Nishi, Kazunobu Saiki, Takeshi Imamura, Keishi Okamoto, Tetsuaki Wakebe, Keiko Ogami, Takashi Hasegawa, Takefumi Moriuchi, Junya Sakamoto, Yoshitaka Manabe, Toshiyuki Tsurumoto
The purpose of this study was to clarify the relevance of degenerative changes in the sacroiliac joint (SIJ) and the joints in the lower limb and lumbar spine using age estimation methods. We also examined the shape of the auricular surface to determine the effect of degenerative changes on each joint. A total of 200 iliac auricular surfaces from 100 Japanese male skeletons were examined macroscopically in accordance with conventional methods of age estimation. From the obtained estimated age, we calculated the deflection values, which represented the degree of degenerative changes of the joints...
June 24, 2016: Anatomical Science International
Haibin Wang, Eric R Helm, Herbie Yung
STUDY DESIGN: non -randomized trial OBJECTIVE.: This is an ex vivo study using pork chops to simulate human vertebra to determine the effects of various anesthetic fluids injectates and concentrations on lesion size and shape created when using cooled radiofrequency ablation. Secondary objective is to determine the effects of various time durations of applied lesion on lesion size created. Our final objective is to determine the effects of fluid injectates on tissue temperature and impedance...
June 15, 2016: Spine
Scott F Farrell, Peter G Osmotherly, Jon Cornwall, Darren A Rivett
BACKGROUND CONTEXT: Innervation of anatomical structures is fundamental to their capacity to generate nociceptive impulses. Cervical spine meniscoids are hypothesised to be contributors to neck pain, however their innervation is not comprehensively understood. PURPOSE: To examine the presence and morphology of nerve fibres within cervical spine meniscoids and adjacent joint capsules. STUDY DESIGN: Cross-sectional study. SAMPLE: Cervical hemispines of 12 embalmed cadavers (mean [SD] age 82...
June 10, 2016: Spine Journal: Official Journal of the North American Spine Society
Ana Mendigutia-Gómez, Carolina Martín-Hernández, Jaime Salom-Moreno, César Fernández-de-Las-Peñas
OBJECTIVE: The purpose of this study was to determine the effects of the inclusion of deep dry needling (DDN) in spastic shoulder muscles into a rehabilitation program on spasticity, pressure pain sensitivity, and shoulder range of motion in subjects who had experienced a stroke. METHODS: A controlled, repeated-measures, crossover, double-blinded, randomized trial was conducted. Twenty patients who have had a stroke were randomly assigned to receive rehabilitation alone or rehabilitation combined with DDN over the upper trapezius, infraspinatus, subscapularis, and pectoralis mayor muscles on the spastic shoulder...
June 2016: Journal of Manipulative and Physiological Therapeutics
María Palacios-Ceña, Lidiane Lima Florencio, Gabriela Natália Ferracini, Johanna Barón, Ángel L Guerrero, Carlos Ordás-Bandera, Lars Arendt-Nielsen, César Fernández-de-Las-Peñas
OBJECTIVE: To investigate widespread pressure hyperalgesia in the trigemino-cervical and extra-trigeminal (distant pain-free) regions in women with episodic and chronic migraine. METHODS: Fifty-one women with episodic migraine, 52 women with chronic migraine, and 52 healthy women without headache history were recruited. Pressure pain thresholds (PPT) were bilaterally assessed over the trigeminal area (i.e., temporalis muscle), cervical area (i.e., C5/C6 zygapophyseal joint), and two extra-trigeminal areas (i...
April 15, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Mats Persson, Jan Sörensen, Björn Gerdle
OBJECTIVE: This study explores the prevalence of facet joint pain in chronic Whiplash Associated Disorder (WAD). DESIGN: Forty-seven patients with chronic WAD were scheduled for medial branch blocks of the cervical spine. METHODS: The patient's localization of the pain together with established pain maps guided to the first level of zygapophyseal joint to be tested. The joint was anesthetized by injecting bupivacaine (0.5 ml; 5 mg/ml) to the medial branches of the cervical dorsal rami above and below the joint...
March 27, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Mattia Pacetti, Pietro Fiaschi, Sergio Gennaro
BACKGROUND: Low back pain is an extremely common and often chronic condition. In some cases, this is due to an irritative arthropathy of zygapophyseal joint involving the medial branch of the dorsal ramus of the spinal nerve. Percutaneous radiofrequency thermocoagulation appears to be the most effective treatment to date, among a range of different treatments. In this paper, the technique is described as performed at out institution. METHODS: In supine position and under fluoroscopic control, a radiofrequency electrode is inserted into different articular zygapophyseal complexes to thermocoagulate ramifications of the medial branch of the dorsal primary ramus of the spinal nerve...
May 2016: Acta Neurochirurgica
Christelle Nguyen, Katherine Sanchez, Alexandra Roren, Clémence Palazzo, Laëtitia Falcou, Jean-Luc Drapé, François Rannou, Serge Poiraudeau, Marie-Martine Lefèvre-Colau
BACKGROUND: Cervical radiculopathy is most often related to foraminal stenosis due to osteoarthritic changes of the uncovertebral joints anteriorly or zygapophyseal joints posteriorly, rather than disc herniation. OBJECTIVES: To describe anatomical specificities of the degenerated cervical spine. METHODS: A critical narrative review was conducted. Articles were non-systematically selected and based on authors' expertise, self-knowledge, and reflective practice...
September 2016: Annals of Physical and Rehabilitation Medicine
Carolina Fernández-Lao, Noelia Galiano-Castillo, Irene Cantarero-Villanueva, Lydia Martín-Martín, Nicolás Prados-Olleta, Manuel Arroyo-Morales
OBJECTIVES: To evaluate widespread pressure pain in patients with chronic plantar heel pain compared with that in healthy controls and to investigate the differences in ultrasound imaging and quality of life between these two groups. METHODS: A total of 22 patients (11 female) with chronic plantar heel pain and the same number of healthy patients, matched according to age and gender, were included in this pilot study. Pressure pain thresholds (PPTs) were bilaterally assessed over the calcaneus bone, the plantar fascia, the first and fifth metatarsals, the soleus muscle, the second metacarpal, and the zygapophyseal joint of C5-C6...
August 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Yan Cheng, Zhaozhong Sun, Rui Li, Qingmin Fang, Guanglin Wang, Jiabin Ren
OBJECTIVE: To investigate the arterials adjacent to the lumbar zygapophyseal joints by anatomy and DSA and aimed to provide a safe operation way for the lumbar back and posterolateral surgery by reducing operative hemorrhage in clinical treatment. METHODS: We selected 20 adult corpse lumbar departments and discovered the lumbar lateral artery and lumbar transverse process artery. Using anatomical microscope to observe the lumber transverse process artery and dosal artery of 1-4 lumber arteries from the lumbar spine 1/2-4/5...
July 21, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Patricia Duff, Basabjit Das, Connail McCrory
BACKGROUND: Percutaneous radiofrequency (RF) rhizotomy of the medial branches of the dorsal rami from the spinal nerves is the standard treatment for cervical zygapophyseal joint mediated pain. There is a paucity of data regarding the longevity of analgesia following this procedure. OBJECTIVE: To determine the duration of complete pain relief, analgesic consumption and any adverse events following percutaneous cervical RF rhizotomy. METHODS: Retrospective chart review of patients who had undergone percutaneous cervical RF rhizotomy for zygapophyseal joint mediated neck pain...
2016: Journal of Back and Musculoskeletal Rehabilitation
David Freiermuth, Martin Kretzschmar, Denis Bilecen, Stefan Schaeren, Augustinus Ludwig Jacob, Armin Aeschbach, Wilhelm Ruppen
OBJECTIVE: Zygapophyseal joints are the origin of pain in up to 30% of those with unspecific chronic low back pain. Until recently, no reliable clinical tests have been found to identify the patients who would benefit from denervation of the zygapophyseal joints by medial branch blockades. DESIGN: We performed a prospective randomized placebo-controlled trial to evaluate the value of high-resolution single-photon emission computed tomography (SPECT)/computed tomography (CT) of the lumbar spine prior to any diagnostic infiltration of the medial branches...
October 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Joshua W Little, Thomas J Grieve, Gregory D Cramer, Jeffrey A Rich, Evelyn E Laptook, Joseph P D Stiefel, Kathleen Linaker
OBJECTIVE: This study tested the reliability of a 5-point ordinal scale used to grade the severity of degenerative changes of zygapophyseal (Z) joints on standard radiographs. METHODS: Modifications were made to a Kellgren grading system to improve agreement for grading the severity of osteoarthritic changes in lumbar Z joints. These included adding 1 grade of no degeneration, multiple radiographic views, and structured examiner training. Thirty packets of radiographic files were obtained, which included representation of all 5 grades including no degeneration (0) and Kellgren's 4-point (1-4) joint degeneration classification criteria...
June 2015: Journal of Manipulative and Physiological Therapeutics
Mario Téllez-García, Ana I de-la-Llave-Rincón, Jaime Salom-Moreno, Maria Palacios-Ceña, Ricardo Ortega-Santiago, César Fernández-de-Las-Peñas
The objective of the current study was to determine the short-term effects of trigger point dry needling (TrP-DN) alone or combined with neuroscience education on pain, disability, kinesiophobia and widespread pressure sensitivity in patients with mechanical low back pain (LBP). Twelve patients with LBP were randomly assigned to receive either TrP-DN (TrP-DN) or TrP-DN plus neuroscience education (TrP-DN + EDU). Pain intensity (Numerical Pain Rating Scale, 0-10), disability (Roland-Morris Disability Questionnaire-RMQ-, Oswestry Low Back Pain Disability Index-ODI), kinesiophobia (Tampa Scale of Kinesiophobia-TSK), and pressure pain thresholds (PPT) over the C5-C6 zygapophyseal joint, transverse process of L3 vertebra, second metacarpal, and tibialis anterior muscle were collected at baseline and 1-week after the intervention...
July 2015: Journal of Bodywork and Movement Therapies
K E Jones
REASONS FOR PERFORMING STUDY: The thoracolumbar region is clinically important in horses; however, the link between joint mobility and bony joint morphology has not been tested quantitatively. OBJECTIVES: To establish which aspects of vertebral morphology correlate with ex vivo range of motion in the thoracolumbar region of Equus caballus, and demonstrate methodologies for linking vertebral form and function. STUDY DESIGN: Morphometric study of osteological specimens...
July 2016: Equine Veterinary Journal
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