Ann Rehabil Med.  2012 Feb;36(1):66-71. 10.5535/arm.2012.36.1.66.

Efficacy of Ultrasonography-Guided Injections in Patients with Facet Syndrome of the Low Lumbar Spine

• Yun DH
• Kim HS
• Yoo SD
• Kim DH
• Chon JM
• Choi SH
• Hwang DG
• Jung PK

• KMID: 2266782
• DOI: http://doi.org/10.5535/arm.2012.36.1.66

Abstract

OBJECTIVE
To investigate the efficacy of ultrasonography (US)-guided injections in patients with low lumbar facet syndrome, compared with that in patients who received fluoroscopy (FS)-guided injections. METHOD: Fifty-seven subjects with facet syndrome of the lumbar spine of the L4-5 and L5-S1 levels were randomly divided into two groups to receive intraarticular injections into the facet joint. One group received FS-guided facet joint injections and the other group received US-guided facet joint injections. Treatment effectiveness was assessed using a visual analogue scale (VAS), physician's and patient's global assessment (PhyGA, PaGA), and the modified Oswestry Disability Index (MODI). All parameters were evaluated four times: before injections, and at a week, a month, and three months after injections. We also measured, in both groups, how long it took to complete the whole procedure.
RESULTS
Each group showed significant improvement from the facet joint injections on the VAS, PhyGA, PaGA, and MODI (p<0.05). However at a week, a month, and three months after injections, no significant differences were observed between the groups with regard to VAS, PhyGA, PaGA, and MODI (p>0.05). Statistically significant differences in procedure time were observed between groups (FS: 248.7+/-6.5 sec; US: 263.4+/-5.9 sec; p=0.023).
CONCLUSION
US-guided injections in patients with lumbar facet syndrome are as effective as FS-guided injections for pain relief and improving activities of daily living.

Keyword

Intraarticular injections; Zygapophysial joint; Low-back pain; Ultrasonography

MeSH Terms

Activities of Daily Living
Fluoroscopy
Humans
Injections, Intra-Articular
Spine
Treatment Outcome
Zygapophyseal Joint

Figure

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  Fig. 1 L4-L5 spinous processes demonstrated in a posterior paravertebral parasagittal sonogram using ultrasonography.

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  Fig. 2 (A) Photograph showing the position of the ultrasonography transducer for examining the left L4-5 lumbar facet joint (B) Sonogram corresponding to the transducer position shown in (A). SP: Spinal process, MF: Medial facet, LF: Lateral facet, Big open arrow: Needle, Small open arrow: Joint space, Small closed arrow: Facet joint capsule.

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