FactFinders for patient safety: Understanding potential procedure-related complications: RFN/multifidus atrophy, intradiscal biologics, and facet cyst rupture

Nguyen, Minh; Saffarian, Mathew; Smith, Clark; Holder, Eric K.; Lee, Haewon; Marshall, Benjamin; Mattie, Ryan; Patel, Jaymin C.; Schneider, Byron J.; McCormick, Zachary L.

doi:10.1016/j.inpm.2023.100248

Cited by 1 publication

(1 citation statement)

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“…115 An analysis of aforementioned studies on behalf of the Spine Intervention Society Patient Safety Committee concluded that despite inconclusive evidence for multifidus atrophy after MBB radiofrequency, some degree of atrophy is plausible but requires further study. 116…”

Section: Com Pl Icat Ion Smentioning

confidence: 99%

3. Pain originating from the lumbar facet joints

Van den Heuvel,

Cohen,

de Andrès Ares

et al. 2023

Pain Practice

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IntroductionPain originating from the lumbar facets can be defined as pain that arises from the innervated structures comprising the joint: the subchondral bone, synovium, synovial folds, and joint capsule. Reported prevalence rates range from 4.8% to over 50% among patients with mechanical low back pain, with diagnosis heavily dependent on the criteria employed. In well‐designed studies, the prevalence is generally between 10% and 20%, increasing with age.MethodsThe literature on the diagnosis and treatment of lumbar facet joint pain was retrieved and summarized.ResultsThere are no pathognomic signs or symptoms of pain originating from the lumbar facet joints. The most common reported symptom is uni‐ or bilateral (in more advanced cases) axial low back pain, which often radiates into the upper legs in a non‐dermatomal distribution. Most patients report an aching type of pain exacerbated by activity, sometimes with morning stiffness. The diagnostic value of abnormal radiologic findings is poor owing to the low specificity. SPECT can accurately identify joint inflammation and has a predictive value for diagnostic lumbar facet injections. After “red flags” are ruled out, conservatives should be considered. In those unresponsive to conservative therapy with symptoms and physical examination suggesting lumbar facet joint pain, a diagnostic/prognostic medial branch block can be performed which remains the most reliable way to select patients for radiofrequency ablation.ConclusionsWell‐selected individuals with chronic low back originating from the facet joints may benefit from lumbar medial branch radiofrequency ablation.

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Section: Com Pl Icat Ion Smentioning

confidence: 99%