Effect of Medial Branch Block in Chronic Facet Joint Pain for Osteoporotic Compression Fracture: One Year Retrospective Study

Overview

Journal Ann Rehabil Med

Specialty Rehabilitation Medicine

Date 2013 May 25

PMID 23705113

Citations 8

Authors

Ki Deok Park

Haemi Jee

Hee Seung Nam

Soo Kyoung Cho

Hyoung Seop Kim

Yongbum Park

Oh Kyung Lim

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the outcomes of medial branch block in facet joint pain for osteoporotic compression fracture and utilize multiple regression, the relationship between their impact on treatment outcome and other factor, such as the radiologic finding, clinical parameters was analyze.

Methods: Fifty-three patients with axial back pain from osteoporotic compression fracture were enrolled. The clinical outcomes were measured by Verbal Numeric Rating Scale (VNS) and Oswestry Disability Index (ODI) before treatment, 2 weeks, 3 months, and 12 months after the medial branch block. Radiographic analysis included measurement of overall sagittal alignment, collapsed vertebral height, and vertebral kyphotic angle. After 12 months, patients' satisfaction was classified to five categories: excellent, good, fair, poor or fail. Statistical analysis of both radiographic and clinical parameters along with treatment outcome was performed to determine any significant correlations between the two.

Results: VNS and ODI was improved 2 weeks after the injection and continued to improve until 12 months. Significant improvement with significant pain relief (>40%), functional improvement (>20%), and the patients rated their satisfaction level as "excellent" or "good" at 12 months after the first injection were observed in 78.9%. The radiographic and clinical parameters were not significantly correlated with treatment outcome.

Conclusion: Our retrospective study demonstrated that the medial branch block provided significant pain relief and functional recovery to the patients with osteoporotic spinal compression fractures complaining of continuous facet joint pain after vertebroplasty or conservative treatment. A placebo-controlled prospective randomized double-blind study should be conducted in the future to evaluate the treatment effects.

Citing Articles

[Lumbar Facet Joint Injection: A Review of Efficacy and Safety].

Do Y, Lee E, Chee C, Lee J J Korean Soc Radiol. 2024; 85(1):54-76.

PMID: 38362388 PMC: 10864157. DOI: 10.3348/jksr.2023.0146.

Vertebroplasty combined with facet joint block vs. vertebroplasty alone in relieving acute pain of osteoporotic vertebral compression fracture: a randomized controlled clinical trial.

Dang S, Wei W, Wei L, Xu J BMC Musculoskelet Disord. 2022; 23(1):807.

PMID: 35999526 PMC: 9396809. DOI: 10.1186/s12891-022-05753-4.

Can facet joint block be a complementary or alternative therapeutic option for patients with osteoporotic vertebral fractures: a meta-analysis.

Chen Z, Song C, Chen J, Sun J, Liu W J Orthop Surg Res. 2022; 17(1):40.

PMID: 35063004 PMC: 8781236. DOI: 10.1186/s13018-022-02933-9.

Dry sauna therapy is beneficial for patients with low back pain.

Cho E, Kim N, Kim H, Yang Y, Kim J, Hwang B Anesth Pain Med (Seoul). 2020; 14(4):474-479.

PMID: 33329780 PMC: 7713799. DOI: 10.17085/apm.2019.14.4.474.

Percutaneous Vertebroplasty and Facet Blocking for Treating Back Pain Caused by Osteoporotic Vertebral Compression Fracture.

Cheng Y, Wu X, Shi J, Jiang H Pain Res Manag. 2020; 2020:5825317.

PMID: 32849933 PMC: 7441434. DOI: 10.1155/2020/5825317.

References

Watts N, Harris S, Genant H . Treatment of painful osteoporotic vertebral fractures with percutaneous vertebroplasty or kyphoplasty. Osteoporos Int. 2001; 12(6):429-37. DOI: 10.1007/s001980170086. View

Cassuto J, Sinclair R, Bonderovic M . Anti-inflammatory properties of local anesthetics and their present and potential clinical implications. Acta Anaesthesiol Scand. 2006; 50(3):265-82. DOI: 10.1111/j.1399-6576.2006.00936.x. View

Georgy B . Interventional techniques in managing persistent pain after vertebral augmentation procedures: a retrospective evaluation. Pain Physician. 2007; 10(5):673-6. View

Mitra R, Do H, Alamin T, Cheng I . Facet pain in thoracic compression fractures. Pain Med. 2010; 11(11):1674-7. DOI: 10.1111/j.1526-4637.2010.00953.x. View

Bogduk N . Evidence-informed management of chronic low back pain with facet injections and radiofrequency neurotomy. Spine J. 2008; 8(1):56-64. DOI: 10.1016/j.spinee.2007.10.010. View

Nam H, Park Y . Effects of transforaminal injection for degenerative lumbar scoliosis combined with spinal stenosis. Ann Rehabil Med. 2012; 35(4):514-23. PMC: 3309239. DOI: 10.5535/arm.2011.35.4.514. View

Manchikanti L, Manchikanti K, Manchukonda R, Pampati V, Cash K . Evaluation of therapeutic thoracic medial branch block effectiveness in chronic thoracic pain: a prospective outcome study with minimum 1-year follow up. Pain Physician. 2006; 9(2):97-105. View

Arner S, Lindblom U, Meyerson B, Molander C . Prolonged relief of neuralgia after regional anesthetic blocks. A call for further experimental and systematic clinical studies. Pain. 1990; 43(3):287-297. DOI: 10.1016/0304-3959(90)90026-A. View

Schwarzer A, Aprill C, Derby R, Fortin J, Kine G, Bogduk N . The false-positive rate of uncontrolled diagnostic blocks of the lumbar zygapophysial joints. Pain. 1994; 58(2):195-200. DOI: 10.1016/0304-3959(94)90199-6. View

10.

Ng L, Chaudhary N, Sell P . The efficacy of corticosteroids in periradicular infiltration for chronic radicular pain: a randomized, double-blind, controlled trial. Spine (Phila Pa 1976). 2005; 30(8):857-62. DOI: 10.1097/01.brs.0000158878.93445.a0. View

11.

Ledlie J, Renfro M . Balloon kyphoplasty: one-year outcomes in vertebral body height restoration, chronic pain, and activity levels. J Neurosurg. 2003; 98(1 Suppl):36-42. DOI: 10.3171/spi.2003.98.1.0036. View

12.

Manchikanti L, Singh V, Falco F, Cash K, Pampati V . Lumbar facet joint nerve blocks in managing chronic facet joint pain: one-year follow-up of a randomized, double-blind controlled trial: Clinical Trial NCT00355914. Pain Physician. 2008; 11(2):121-32. View

13.

Reid D, Hu R, Davis L, Saboe L . The nonoperative treatment of burst fractures of the thoracolumbar junction. J Trauma. 1988; 28(8):1188-94. DOI: 10.1097/00005373-198808000-00009. View

14.

Lee H, Weinstein J, Meller S, Hayashi N, Spratt K, Gebhart G . The role of steroids and their effects on phospholipase A2. An animal model of radiculopathy. Spine (Phila Pa 1976). 1998; 23(11):1191-6. DOI: 10.1097/00007632-199806010-00001. View

15.

Manchikanti L, Staats P, Singh V, Schultz D, Vilims B, Jasper J . Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician. 2006; 6(1):3-81. View

16.

Campbell W, Kendrick R . Pre-emptive analgesia using local anaesthesia: a study in bilaterally symmetrical surgery. Br J Anaesth. 1998; 79(5):657-9. DOI: 10.1093/bja/79.5.657. View

17.

Katz W, Rothenberg R . Section 3: The nature of pain: pathophysiology. J Clin Rheumatol. 2005; 11(2 Suppl):S11-5. DOI: 10.1097/01.rhu.0000158686.43637.af. View

18.

Lee I, Kim S, Lee J, Hong S, Choi J, Kang H . Comparison of the temporary diagnostic relief of transforaminal epidural steroid injection approaches: conventional versus posterolateral technique. AJNR Am J Neuroradiol. 2007; 28(2):204-8. PMC: 7977402. View

19.

Beaman D, Graziano G, Glover R, Wojtys E, Chang V . Substance P innervation of lumbar spine facet joints. Spine (Phila Pa 1976). 1993; 18(8):1044-9. DOI: 10.1097/00007632-199306150-00014. View

20.

Boswell M, Shah R, Everett C, Sehgal N, McKenzie Brown A, Abdi S . Interventional techniques in the management of chronic spinal pain: evidence-based practice guidelines. Pain Physician. 2006; 8(1):1-47. View