Facet and Selective Nerve Root Blocks as a Diagnostic and Therapeutic Alternative in Patients with Chronic Low Back Pain

  • Micaela Cinalli Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina https://orcid.org/0000-0003-2057-4469
  • Pedro Luis Bazán Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina http://orcid.org/0000-0003-0060-6558
  • Martín Medina Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina https://orcid.org/0000-0002-5281-5645
  • Álvaro Enrique Borri Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina https://orcid.org/0000-0002-5568-867X
Keywords: Low back pain, facet block, selective root block, tomography, radioscopy

Abstract

Introduction: Intra-articular facet blocks and selective nerve root blocks are useful as a diagnostic and therapeutic method for the management of chronic low back pain. The objective of this study was to describe and analyze the results of these blocks. Materials and Methods: A retrospective cohort study was conducted with data from patients undergoing CT-guided intra-articular facet block and selective nerve root block between January 2014 and February 2015. The demographic information, the visual analog scale’s score before and after the block, and their relationships to the outcomes were analyzed. Results: The study included 68 patients with intra-articular facet block and 89 with selective nerve root block. In both groups, pain improved significantly (p < 0.05). There was an association between the improvement in pain with intra-articular facet blocks and gender and age, and between the improvement achieved by selective nerve root blocks and the type of initial pain. Conclusions: Intra-articular facet blocks and selective nerve root blocks are a useful diagnostic method in the management of chronic low back pain and their therapeutic action is significant, although studies are needed to know their analgesic effect in the medium and long term, in order to improve the quality of life of patients.

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Author Biographies

Micaela Cinalli, Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Pedro Luis Bazán, Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Martín Medina, Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Álvaro Enrique Borri, Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina

References

Deyo RA, Weinstein JN. Low back pain. N Engl J Med 2001;344(5):363-70. https://doi.org/10.1056/NEJM200102013440508

O’Connell NE, Cook CE, Wand BM, Ward SP. Clinical guidelines for low back pain: a critical review of consensus

and inconsistencies across three major guidelines. Best Pract Res Clin Rheumatol 2016;30(6):1-13.

https://doi.org/10.1016/j.berh.2017.05.001

Perolat R, Kastler A, Nicot B, Pellat JM, Tahon F, Attye A, et al. Facet joint syndrome: from diagnosis to

interventional management. Insights Imaging 2018;9:773-89. https://doi.org/10.1007/s13244-018-0638-x

Won HS, Yang M, Kim YD. Facet joint injections for management of low back pain: clinically focused review.

Anesth Pain Med 2020;15(1):8-18. https://doi.org/10.17085/apm.2020.15.1.8

Cobeñas R, Flórez J, Chiaradia P, Ruiz Salgado K, Del Vedia M, Paba M, et al. Bloqueos nerviosos corticoideobupivacaína: ¿La mejoría post-procedimiento inmediato predice el éxito terapéutico a mediano plazo? Rev Argent Radiol 2021;2:31-54. https://doi.org/10.1055/s-0040-1721349

Hofmann U, Keller R, Walter C, Mittag F. Predictability of the effects of facet joint infiltratrion in the degenerate

lumbar spine when assessing MRI scans. J Orthop Surg Res 2017;12(1)180. https://doi.org/10.1186/s13018-017-0685-x

Wenger HC, Cifu AS. Treatment of low back pain. JAMA 2017;318(8):743-4. https://doi.org/10.1001/jama.2017.9386.

Insausti Valdivia J. Lumbalgia inespecífica: En busca del origen del dolor. Reumatol Clin 2009;5(S2):19-26.

Disponible en: https://www.reumatologiaclinica.org/es-pdf-S1699258X09001466

Arum-Kumar K, Jayaprasad S, Senthil K, Lohith H, Jayaprakash KV. The outcomes of selective nerve root block for disc induced lumbar radiculopathy. Malays Orthop J 2015;9(3):17-22. https://doi.org/10.5704/MOJ.1511.002

González FJ, Adén M. Bloqueo radicular lumbar selectivo guiado por TAC. Alternativa para diagnóstico y

tratamiento de radiculopatías originadas por hernias discales y/o artrosis facetaria. Rev Fac Med 2011;31(2):11-4.

https://doi.org/10.30972/med.3122418

Eyheremendy E. Infiltraciones percutáneas guiadas por imágenes en el manejo del dolor lumbar. Rev Asoc Argent Ortop Traumatol 2007;72:85-90. Disponible en: https://www.aaot.org.ar/revista/2007/n1_vol72/art15.pdf

Nielsen AJ, Criscuolo G, González Calvo S, Larrañaga N, Gallo JC, Kozima S. Bloqueo nervioso lumbar selectivo guiado por tomografía computada. Nuestra experiencia en un hospital universitario. Rev Argent Radiol

;77(3):226-30. https://doi.org/10.7811/rarv77n3a08

Kanaan T, Abusaleh R, Al Jammal M, Al-Haded S, Al-Rafaiah S, Kanaan A, et al. The efficacy of therapeutic

selective nerve block in treating lumbar radiculopathy and avoiding surgery. J Pain Res 2020;13:2971-8.

https://doi.org/10.2147 / JPR.S276331

Wiswanathan VK, Mugesh Kanna R, Farhadi HF. Role of transforaminal epidural injections of selective nerve root blocks in the management of lumbar radicular syndrome-A narrative, evidence-bases review. J Clin Orthop Trauma 2020;11(5):802-9. https://doi.org/10.1016 / j.jcot.2020.06.004

Cohen SP, Wallacec M, Rauckd RL, Staceye BR. Unique aspects of clinical trials of invasive therapies for chronic

pain. Pain Rep 2018;4(3):e687. https://doi.org/10.1097/PR9.0000000000000687

Ospina Á, Campuzano D, Hincapié E, Vásquez, LF, Montoya E, Zapata IC. Eficacia del bloqueo facetario en

pacientes con síndrome facetario lumbar. Rev Colom Anestesiol 2012;40(3):177-82. Disponible en:

https://www.redalyc.org/articulo.oa?id=195124163003

Published
2023-06-17
How to Cite
Cinalli, M., Bazán, P. L., Medina, M., & Borri, Álvaro E. (2023). Facet and Selective Nerve Root Blocks as a Diagnostic and Therapeutic Alternative in Patients with Chronic Low Back Pain. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 88(3), 296-301. https://doi.org/10.15417/issn.1852-7434.2023.88.3.1514
Section
Clinical Research

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