Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Effectiveness of Facet Joint Infiltration in Low Back Pain.
Ribeiro, Luiza H. C., Furtado, Rita V., Konai, Monique, Rosenfeld, Andre, Andreo, Ana B., Natour, Jamil
Lumbar facet joints are a well recognized source of low back pain. Studies have shown the prevalence of lumbar facet joint pain in 30% to 40% of the patients with chronic low back pain. Facet joint interventions, including intra-articular injections, medial branch nerve blocks, and neurotomy by radiofrequency are used to manage chronic facet-mediated spinal pain. Several studies have been evaluated the effectiveness of these interventions. Results of facet joint infiltration, however, are conflicting.The aim of this study is to evaluate the effectiveness of facet joint infiltration with corticosteroids in patients with facet joint syndrome.
Sixty subjects with diagnostic of facet joint syndrome were enrolled in the study. They were randomized into experimental and control groups. The experimental group was submitted to intra-articular infiltration of six facet joints (L3/L4;L4/L5;L5/S1 bilaterally) with triamcinolone hexacetonide. The control group was submitted to triamcinolone acetonide intramuscular injection of six lumbar paravertebral points. After the randomization, all subjects were assessed by an investigator blinded to the groups. The assessment were taken just before the interventions (T0) and them 7, 30, 90 and 180 days after the interventions. The following assessment instruments were used: pain visual analogical scale (VAS) (010cm), pain visual analogical scale during extension of the spine (VAS E) (010cm), Likert scale for improving (05), percentage scale of subjective improving perception(0100%), Rolland-Morris questionnaire (024), short health survey questionnaire (SF36), accountability of medications taken for back pain: analgesics and non-steroidal antiinflamatories (NSAIDs). Statistical analysis: the homogeneity of the sample was tested using Student's T, Pearson's Chi- Square and Mann-Whitney tests. ANOVA with repeated measures was performed to evaluate inter- and intra-group differences. A 5% significance level was used for all variables and tests.
There were no significant differences in the baseline characteristics between the two groups. The experimental group showed a significant improvement in the physical aspects domain, assessed by SF-36. At visit 7 the experimental group showed a better response of improving (much better) assessed by the Likert scale. However in the following visits both groups had similar results. The consumption of NSAIDs were significantly lower in the experimental group at the last visit (T180).
Facet joint infiltration had a weak effectiveness. The improvement was observed in few aspects of quality of life and self-assessment of improving. However it provided a reduction in NSAIDs intake.
To cite this abstract, please use the following information:
Ribeiro, Luiza H. C., Furtado, Rita V., Konai, Monique, Rosenfeld, Andre, Andreo, Ana B., Natour, Jamil; Effectiveness of Facet Joint Infiltration in Low Back Pain. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1719