Title: A Study to Determine the Clinical Efficacy of Spinal Facet Joint Intervention with Medial Branch Block in Patients of Chronic Low Back Pain with Radiation Associated with Facet Arthropathy

Authors: Dr Siddhartha Sinha Ray, Dr Kshetra Madhab Das, Prof. (Dr.) Nityananda Kar

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i5.51

Abstract

Facetogenic back pain results from involvement of spinal zygapophyseal or facet joints. The common symptoms are diffuse back pain, localized tenderness at facet joints, reduced functionality. Lumbar radiculopathy due to facet hypertrophy is also a well known neurological condition. Facet arthropathy can be diagnosed clinically by local tenderness and quadrant loading test and by MRI with evidence of facet hypertrophy while the best known clinical test for lumbar radiculopathy is straight leg raising (SLR) test. 

Nerve block with steroid and local aneasthetic at Medial Branch of dorsal rami, which supplies facet joint is a very common minimally invasive procedure in the treatment of facet arthropathy. The aim of our study was to observe the efficacy of Medial Branch Block (MBB) in the treatment of low back pain (LBP) with radiation associated with facet hypertrophy.

Twenty nine patients, included in the study as per inclusion criteria, were treated with MBB apart from getting other conventional pharmacological and non pharmacological conservative managements. They were assessed on the day of intervention and at two weeks follow up, for the parameters of back pain, facet joint tenderness, SLR and activity.

Finally twenty four patients completed the study and the resultant data was analysed with appropriate statistical tools. All the parameters had shown statistically significant improvement over follow up.  SLR on the ipsilateral side has shown better improvement than contralateral side. This short term study indicates towards the efficacy of MBB in controlling both LBP and radiating pain in patients suffering from facet hypertrophy.

Keywords: Facet Hypertrophy, Zygapophyseal Joint, Medial Branch Block, Low Back Pain, Facet Joint Intervention.

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Corresponding Author

Dr Kshetra Madhab Das

Flat - 4N, Block - A, Sherwood Estate, 169 N S C Bose Road,

Kolkata, West Bengal, India, Pin-700103

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