Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Feb;36(1):66-71.
doi: 10.5535/arm.2012.36.1.66. Epub 2012 Feb 29.

Efficacy of ultrasonography-guided injections in patients with facet syndrome of the low lumbar spine

Dong Hwan Yun  1 , Hee-Sang Kim, Seung Don Yoo, Dong Hwan Kim, Jinn Man Chon, Seong He Choi, Dae Gyu Hwang, Pil Kyo Jung
Affiliations

Efficacy of ultrasonography-guided injections in patients with facet syndrome of the low lumbar spine

Dong Hwan Yun et al. Ann Rehabil Med. 2012 Feb.

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.

Keywords: Intraarticular injections; Low-back pain; Ultrasonography; Zygapophysial joint.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
L4-L5 spinous processes demonstrated in a posterior paravertebral parasagittal sonogram using ultrasonography.
Fig. 2
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.
See this image and copyright information in PMC

References

    1. Boswell MV, Colson JD, Spillane WF. Therapeutic facet joint interventions in chronic spinal pain: a systematic review of effectiveness and complications. Pain Physician. 2005;8:101–114. - PubMed
    1. Sehgal N, Shah RV, McKenzie-Brown AM, Everett CR. Diagnostic utility of facet (zygapophysial) joint injections in chronic spinal pain: a systematic review of evidence. Pain Physician. 2005;8:211–224. - PubMed
    1. Joy H, Ha SK, Kim SH, Lim DJ, Park JY, Suh JK. Prognostic factors of percutaneous radiofrequency neurotomy on the posterior primary ramus. J Korean Neurosurg Soc. 2003;33:51–55.
    1. Bogduk N. International Spinal Injections Society guidelines for the performance of spinal injections procedures. Part I: Zygapophysial joint blocks. Clin J Pain. 1997;13:285–302. - PubMed
    1. Greher M, Kirchmair L, Enna B, Kovacs P, Gustorff B, Kapral S, Moriggl B. Ultrasound-guided lumbar facet nerve block: accuracy of a new technique confirmed by computed tomography. Anesthesiology. 2004;101:1195–1200. - PubMed

LinkOut - more resources