Local Infiltrations in Patients with Radiculopathy or Chronic Low Back Pain Due to Segment Degeneration-Only A Diagnostic Value?

被引：2
|
作者：
Lindemann, Chris [1 ]
Zippelius, Timo [2 ]
Hochberger, Felix [3 ]
Hoelzl, Alexander [1 ]
Boehle, Sabrina [1 ]
Strube, Patrick [1 ]
机构：
[1] Jena Univ Hosp, Orthoped Dept, Campus Eisenberg, D-07607 Eisenberg, Germany
[2] Univ Ulm, Dept Orthoped Surg, D-89081 Ulm, Germany
[3] Tech Univ Munich, Dept Orthoped Sports Med, Klinikum Rechts Isar, D-81675 Munich, Germany
来源：
JOURNAL OF PERSONALIZED MEDICINE | 2022年 / 12卷 / 11期
关键词：
facet joint capsule infiltration; periradicular infiltration; selective nerve block; radiculopathy; low back pain; LUMBAR DISC HERNIATION; PERIRADICULAR INFILTRATION; CORTICOSTEROID INJECTIONS; CLINICAL IMPORTANCE; NATURAL-HISTORY; HEALTH-STATUS; FACET JOINTS; OSTEOARTHRITIS; SCIATICA; EFFICACY;
D O I：
10.3390/jpm12111791
中图分类号：
R19 [保健组织与事业（卫生事业管理）];
学科分类号：
摘要：
The purpose of this study was to investigate the differences in the therapeutic effectiveness of CT-assisted infiltration of a local anesthetic + corticosteroid between nerve root and facet joint capsule in patients with chronic complaints. In this prospective trial with a 12-month follow-up, a total of 250 patients with chronic low back pain and radiculopathy were assigned to two groups. In the first group, patients with specific lumbar pain due to spondyloarthritis received periarticular facet joint capsule infiltration (FJI). In the second group, patients with monoradicular pain received periradicular infiltration (PRI) via an extraforaminal selective nerve block. Clinical improvement after FJI and PRI regarding pain (NRS), function (ODI), satisfaction (McNab), and health related quality of life (SF-36) were compared. Minimally clinically important difference (MCID) served as the threshold for therapeutic effectiveness evaluation. A total of 196 patients were available for final analysis. With respect to the pain reduction and functional improvement (ODI, NRSoverall, and NRSback), the PRI group performed significantly better (ptreatment < 0.001) and longer over time (ptreatment x time 0.001) than the FJI group. Regarding pain and function, only PRI demonstrated a durable improvement larger than MCID. A significant and durable therapeutic value was found only after receiving PRI but not after FJI in patients with chronic pain.
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页数：12
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