Clinical Features of Patients with Pain Stemming from the Lumbar Zygapophysial Joints

Schwarzer, Anthony C.; Aprill, Charles; Derby, Richard; Fortin, Joseph D.; Kine, Garrett; Bogduk, Nikolai

doi:10.1097/00007632-199405001-00006

Cited by 543 publications

(342 citation statements)

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“…The ENMG even in the root compression has accuracy that range between 20 and 90%, and it becomes more difficult to interpreting in the postoperative, when other injuries can cause nerve irritation 2 . There are lacks of controlled studies about nervous root and the zygapophyseal joint blockade anesthetic and the specificities is not clear, beyond some authors thought that the existence of the facet syndrome must be questioned 18 . The used of discography for many services is also controversy, mainly when it is used in operated patients where up to 40% of the asymptomatic present positive test, and for the no-operated patient it must have an adequate election and follow the established criteria for positivity and injection pressure 19,20 .…”

Section: Discussionmentioning

confidence: 99%

Failed back surgery syndrome: casuistic and etiology

Rodrigues

Dozza

Oliveira

et al. 2006

Arq. Neuro-Psiquiatr.

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OBJECTIVE: To report our data of cases of failed back surgery syndrome (FBSS) and surgical and nonsurgical etiologies. METHOD: The medical charts of 121 patients submitted to laminectomy, hemilaminectomy combined with discectomy and/or foraminotomy between January 1997 and October 2004 in the Instituto of Neurologia Deolindo Couto were reviewed. The inclusion criterion was does not improve or the symptoms return after the surgery and with a minimum of three medical consultations with adequate investigation for the diagnosis. The patients had been divided in three main pre-surgical diagnosis: herniated disc, lumbar stenosis and the association of these. RESULTS: From the 121 patients submitted to spine surgical intervention, 47 (38.8%) had presented criteria for the FBSS. Among the 26 patients who had presented operative diagnosis of lumbar stenosis, 8 (30.7%) had presented FBSS; of the 83 with disc herniation, 31 (37.3%) had the syndrome; and the 12 patients with lumbar stenosis associated with disc herniation, 7 (58.3%) had failure of the back surgery. CONCLUSION: The failure of back surgery remains a challenge for the surgeons. There is an incessant search for the causes and the action mechanisms of this syndrome and the best method of treatment.

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Section: Discussionmentioning

confidence: 99%

Failed back surgery syndrome: casuistic and etiology

Rodrigues

Dozza

Oliveira

et al. 2006

Arq. Neuro-Psiquiatr.

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“…Facet arthropathy in lumbar area causes low back pain with radiation to the buttock and posterior-lateral thigh (rarely below knee) on the affected side [24][25][26][27]. The pain is exacerbated by extension and side bending (twisting) on affected side and decreases on flexion.…”

Section: Clinical Presentationmentioning

confidence: 99%

Low Back Pain due to Lumbar Facet Joint Arthropathy and its Management

Jadon¹

2016

Gen Med (Los Angeles)

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Low back pain is a very common problem which brings a patient to orthopedic clinic or pain clinic. It is estimated that it affects about 60-80% of general population in the whole life and facet joints are responsible for back pain in 15%-45% of such cases. Multimodal approach including analgesics and back strengthening exercise are primary treatments. However, sustained relief can be achieved by radiofrequency ablation after proper diagnosis.

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“…The identification of a painful joint seems difficult, because the literature does not report any correlation between the clinical symptoms of low back pain and degenerative spinal changes on radiological imaging studies [11], including radiographs, magnetic resonance imaging (MRI), and computed tomography [8] [9]. Specifically, the association between degenerative changes in the lumbar facet joints and symptomatic low back pain remains unclear and is a subject of ongoing debate [5] [6] [7] [8]. The prevalence of abnormal zygapophysial joint changes in radiological imaging depends on the age of the study population, the imaging modality used, and the threshold of abnormality used.…”

Section: Introductionmentioning

confidence: 99%

Association between Magnetic Resonance Imaging and the Result of Medial Branch Blocks

Klessinger

Freund

2017

PST

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The aim of this retrospective practice audit was to assess the correlation between painful zygapophysial joints and changes seen in magnetic resonance imaging (MRI). Patients with unilateral pain were tested with controlled medial branch blocks. The MRI scans of patients with a positive response were compared blinded with normal MRI scans. The dimensions of the joint were assessed and osteoarthritis was graded. Fifteen symptomatic patients and 15 asymptomatic patients were included and evaluated. Comparison of the joints showed that the maximum diameter of symptomatic joints was significantly larger, and the grading of osteoarthritis was significantly higher for symptomatic joints. No healthy patient was assigned a grade 3. Grades 2 and 3 were found significantly more often in symptomatic patients. Only one symptomatic joint was assigned grade 0. Grade 0 was found significantly more often in asymptomatic patients. The presented MRI technique has limited value as a diagnostic test for lumbar zygapophysial joint pain. It is not possible to detect a single symptomatic joint. However, the osteoarthritis grading for the lumbar zygapophysial joints might be helpful for finding predictors for negative response if the results of the rating are grade zero. Therefore, unnecessary medial branch blocks might be avoided.

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Clinical Features of Patients with Pain Stemming from the Lumbar Zygapophysial Joints

Cited by 543 publications

References 0 publications

Failed back surgery syndrome: casuistic and etiology

Failed back surgery syndrome: casuistic and etiology

Low Back Pain due to Lumbar Facet Joint Arthropathy and its Management

Association between Magnetic Resonance Imaging and the Result of Medial Branch Blocks

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