原创力文档diagnostic value of lumbar facet joint injection a prospective triple cross-over study诊断价值的腰椎方面联合注入一个前瞻性三交叉研究.pdfVIP
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diagnostic value of lumbar facet joint injection a prospective triple cross-over study诊断价值的腰椎方面联合注入一个前瞻性三交叉研究
Diagnostic Value of Lumbar Facet Joint Injection: A
Prospective Triple Cross-Over Study
¨ 1 2 ¨ 3 4 4
Uwe Schutz *, Balkan Cakir , Karsten Dreinhofer , Marcus Richter , Holger Koepp
1 Department of Diagnostic and Interventional Radiology, University of Ulm, Ulm, Germany, 2 Department of Orthopedics, University of Ulm, Ulm, Germany, 3 Institute for
´ ¨
muskuloskeletal Rehabilitation, Prevention and Health Service Research at Charite Universitatsmedizin Berlin, CSSB and CMSC, Berlin, Germany, 4 Spine Center, St. Josefs-
Hospital, Wiesbaden, Germany
Abstract
The diagnosis ‘‘lumbar facet syndrome’’ is common and often indicates severe lumbar spine surgery procedures. It is
doubtful whether a painful facet joint (FJ) can be identified by a single FJ block. The aim of this study was to clarify the
validity of a single and placebo controlled bilateral FJ blocks using local anesthetics. A prospective single blinded triple
cross-over study was performed. 60 patients (31 f, 29 m, mean age 53.2 yrs (22–73)) with chronic low back pain (mean pain
persistance 31 months, 6 months of conservative treatment without success) admitted to a local orthopaedic department
for surgical or conservative therapy of chronic LBP, were included in the study. Effect on pain reduction (10 point rating
scale) was measured. The 60 subjects were divided into six groups with three defined sequences of fluoroscopically guided
bilateral monosegmental lumbar FJ test injections in ‘‘oblique needle’’ technique: verum-(local anaesthetic-), placebo-
(sodium chloride-) and sham-injection. Carry-over and periodic effects were evaluated and a descriptive and statistical
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