Success of initial and repeated medial branch neurotomy for zygapophysial joint pain: a systematic review. Smuck M, Crisostomo RA, Trivedi K, Agrawal D. PM R 2012;4(9):686–92

2012 ◽  
Vol 12 (12) ◽  
pp. 1170
Keyword(s):  
Systematic Review ◽  
Joint Pain ◽  
Medial Branch ◽  
Zygapophysial Joint

Success of Initial and Repeated Medial Branch Neurotomy for Zygapophysial Joint Pain: A Systematic Review

PM&R ◽  
2012 ◽  
Vol 4 (9) ◽  
pp. 686-692 ◽  
Author(s):  
Matthew Smuck ◽  
Ralph A. Crisostomo ◽  
Kavita Trivedi ◽  
Divya Agrawal
Keyword(s):  
Systematic Review ◽  
Joint Pain ◽  
Medial Branch ◽  
Zygapophysial Joint

scholarly journals Systematic Review of the Therapeutic Effectiveness of Cervical Facet Joint Interventions: An Update

2012 ◽  
Vol 6;15 (6;12) ◽  
pp. E839-E868 ◽  
Author(s):  
Frank J.E. Falco
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Joint Pain ◽  
Observational Studies ◽  
Facet Joint ◽  
Medial Branch ◽  
Radiofrequency Neurotomy ◽  
Facet Joint Interventions ◽  
Cervical Facet ◽  
Cervical Facet Joint

Background: The prevalence of chronic, recurrent neck pain is approximately 15% of the adult general population. Controlled studies have supported the existence of cervical facet or zygapophysial joint pain in 36% to 67% of these patients, when disc herniation, radiculitis, and discogenic are not pathognomic. However, these studies also have shown false-positive results in 27% to 63% of the patients with a single diagnostic block. There is also a paucity of literature investigating therapeutic interventions of cervical facet joint pain. Study Design: Systematic review of therapeutic cervical facet joint interventions. Objective: To determine and update the clinical utility of therapeutic cervical facet joint interventions in the management of chronic neck pain. Methods: The available literature for utility of facet joint interventions in therapeutic management of cervical facet joint pain was reviewed. The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria as utilized for interventional techniques for randomized trials and the criteria developed by the Newcastle-Ottawa Scale criteria for observational studies. The level of evidence was classified as good, fair, and limited or poor based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to June 2012, and manual searches of the bibliographies of known primary and review articles. Outcome Measures: The primary outcome measure was pain relief (short-term relief = up to 6 months and long-term > 6 months). Secondary outcome measures were improvement in functional status, psychological status, return to work, and reduction in opioid intake. Results: In this systematic review, 32 manuscripts were considered for inclusion. For final analysis, 4 randomized trials and 6 observational studies met the inclusion criteria and were included in the evidence synthesis. Based on one randomized, sham-controlled, double-blind trial and 5 observational studies, the indicated evidence for cervical radiofrequency neurotomy is fair. Based on one randomized, double-blind, active-controlled trial and one prospective evaluation, the indicated evidence for cervical medial branch blocks is fair. Based on 2 randomized controlled trials, the evidence for cervical intraarticular injections is limited. Limitations: Paucity of the overall published literature and specifically lack of literature for intraarticular cervical facet joint injections. Conclusions: The indicated evidence for cervical radiofrequency neurotomy is fair. The indicated evidence for cervical medial branch blocks is fair. The indicated evidence for cervical intraarticular injections with local anesthetic and steroids is limited. Key words: Chronic neck pain, cervical facet or zygapophysial joint pain, cervical medial branch blocks, cervical radiofrequency neurotomy, cervical intraarticular facet joint injections

scholarly journals An Update of Evaluation of Therapeutic Thoracic Facet Joint Interventions

2012 ◽  
Vol 4;15 (4;8) ◽  
pp. E463-E481
Author(s):  
Frank J.E. Falco
Keyword(s):  
Systematic Review ◽  
Back Pain ◽  
Quality Assessment ◽  
Joint Pain ◽  
Facet Joint ◽  
Medial Branch ◽  
Facet Joints ◽  
Nerve Blocks ◽  
Radiofrequency Neurotomy ◽  
Facet Joint Interventions

Background: Chronic mid back and upper back pain caused by thoracic facet joints has been reported in 34% to 48% of patients based on responses to controlled diagnostic blocks. Systematic reviews have established moderate evidence for controlled comparative local anesthetic blocks of thoracic facet joints in the diagnosis of mid back and upper back pain, moderate evidence for therapeutic thoracic medial branch blocks, and limited evidence for radiofrequency neurotomy of thoracic medial branches. Study Design: Systematic review of therapeutic thoracic facet joint interventions. Objective: To determine the clinical utility of therapeutic thoracic facet joint interventions in the therapeutic management of chronic upper back and mid back pain. Methods: The available literature for the utility of facet joint interventions in the therapeutic management of thoracic facet joint pain was reviewed. The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria as utilized for interventional techniques for randomized trials and the criteria developed by the Newcastle-Ottawa Scale criteria for observational studies. The level of evidence was classified as good, fair, and limited (or poor) based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to March 2012, and manual searches of the bibliographies of known primary and review articles. Outcome Measures: The primary outcome measure was pain relief (short-term relief = up to 6 months and long-term > 6 months). Secondary outcome measures were improvement in functional status, psychological status, return to work, and reduction in opioid intake. Results: For this systematic review, 13 studies were identified. Of these, 7 studies were excluded, and a total of 4 studies (after removal of duplicate publication) met inclusion criteria for methodological quality assessment with one randomized trial and 3 non-randomized studies. The evidence is fair for therapeutic thoracic facet joint nerve blocks, limited for thoracic radiofrequency neurotomy, and not available for thoracic intraarticular injections. Limitations: The limitation of this systematic review includes a paucity of literature. The only positive studies were of medial branch blocks performed by the same group of authors. Conclusion: The evidence for therapeutic facet joint interventions is fair for medial branch blocks, whereas it is not available for intraarticular injections, and limited for radiofrequency neurotomy due to lack of literature. Key words: Chronic thoracic pain, mid back or upper back pain, thoracic facet or zygapophysial joint pain, facet joint nerve blocks, medial branch blocks, therapeutic thoracic medial branch blocks, thoracic radiofrequency neurotomy, thoracic intraarticular facet joint injections

scholarly journals Clinical Diagnostic Tests versus Medial Branch Blocks for Adults with Persisting Cervical Zygapophyseal Joint Pain: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 70 (2) ◽  
pp. 179-187
Author(s):  
Kendra Usunier ◽  
Mark Hynes ◽  
James Michael Schuster ◽  
Annie Cornelio-Jin Suen ◽  
Jackie Sadi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Tests ◽  
Joint Pain ◽  
Meta Analysis ◽  
Medial Branch ◽  
Zygapophyseal Joint ◽  
Clinical Diagnostic

Pathogenesis, Diagnosis, and Treatment of Lumbar Zygapophysial (Facet) Joint Pain

2007 ◽  
Vol 106 (3) ◽  
pp. 591-614 ◽  
Author(s):  
Steven P. Cohen ◽  
Srinivasa N. Raja
Keyword(s):  
Joint Pain ◽  
Facet Joint ◽  
Diagnosis And Treatment ◽  
Treatment Modalities ◽  
Medial Branch ◽  
Systematic Analysis ◽  
Zygapophysial Joint ◽  
Radiofrequency Denervation ◽  
Facet Joint Pain ◽  
Lumbar Facet

Lumbar zygapophysial joint arthropathy is a challenging condition affecting up to 15% of patients with chronic low back pain. The onset of lumbar facet joint pain is usually insidious, with predisposing factors including spondylolisthesis, degenerative disc pathology, and old age. Despite previous reports of a "facet syndrome," the existing literature does not support the use of historic or physical examination findings to diagnose lumbar zygapophysial joint pain. The most accepted method for diagnosing pain arising from the lumbar facet joints is with low-volume intraarticular or medial branch blocks, both of which are associated with high false-positive rates. Standard treatment modalities for lumbar zygapophysial joint pain include intraarticular steroid injections and radiofrequency denervation of the medial branches innervating the joints, but the evidence supporting both of these is conflicting. In this article, the authors provide a comprehensive review of the anatomy, biomechanics, and function of the lumbar zygapophysial joints, along with a systematic analysis of the diagnosis and treatment of facet joint pain.

Comparison of Intra-articular Thoracic Facet Joint Steroid Injection and Thoracic Medial Branch Block for the Management of Thoracic Facet Joint Pain

Spine ◽  
2018 ◽  
Vol 43 (2) ◽  
pp. 76-80 ◽  
Author(s):  
Dong Gyu Lee ◽  
Sang Ho Ahn ◽  
Yun Woo Cho ◽  
Kyung Hee Do ◽  
Sang Gyu Kwak ◽  
...  
Keyword(s):  
Joint Pain ◽  
Facet Joint ◽  
Steroid Injection ◽  
Medial Branch ◽  
Medial Branch Block ◽  
Facet Joint Pain
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