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The Effect of Facet Joint Injection Versus Systemic Steroids in Low Back Pain: A Randomized Controlled Trial
Ribeiro, Luiza Helena PhD; Vilar Furtado, Rita Neli PhD; Konai, Monique MD; Andreo, Ana Beatriz MD; Rosenfeld, Andre MD; Natour, Jamil PhD
Study Design. Randomized clinical trial
Objective. to compare the effectiveness of facet joint injection versus systemic steroid in patient with diagnosis of facet joint syndrome.
Summary of Background Data. The term facet joint syndrome has been used to define back pain originating from the facet joints. Treatment is mainly conservative, although interventions, including intraarticular injections and medial branch nerve blocks are used to manage facet-mediated pain. Several studies have evaluated the effectiveness of these interventions. Results of facet joint injection, however, are conflicting.
Methods. Sixty subjects with diagnosis of facet joint syndrome were enrolled in the study. They were randomized into experimental and control groups. The experimental group was submitted to intraarticular injection of six lumbar facet joints with triamcinolone hexacetonide; the control group was submitted to triamcinolone acetonide intramuscular injection of six lumbar paravertebral points. Visits were taken at baseline and at 1, 4, 12 and 24 weeks after interventions. Outcome measures were used: pain visual analogical scale, pain visual analogical scale during extension of the spine, Likert scale, improvement percentage scale, Rolland-Morris, short health survey (SF36), accountability of medications taken.
Homogeneity was tested using Student's T, Pearson's Chi- Square and Mann-Whitney tests. ANOVA was used to analyze differences in the groups over time and the Student's t-test to analyze differences between groups at each time evaluation.
Results. The groups were similar at baseline. Comparisons between the groups showed, in ANOVA analysis, an improvement in the experimental group regarding diclofenac intake and quality of life, in the "role physical" profile, assessed by SF-36.
In the analysis at each time point, an improvement in the experimental group was also found in Rolland Morris, in the improvement percentage scale and in the response to treatment, assessed by the Likert scale.
Conclusion. Both treatments were effective, with a slightly superiority of the intraarticular injection of steroids over intramuscular injection.
Ribeiro, Luiza Helena PhD; Vilar Furtado, Rita Neli PhD; Konai, Monique MD; Andreo, Ana Beatriz MD; Rosenfeld, Andre MD; Natour, Jamil PhD
Study Design. Randomized clinical trial
Objective. to compare the effectiveness of facet joint injection versus systemic steroid in patient with diagnosis of facet joint syndrome.
Summary of Background Data. The term facet joint syndrome has been used to define back pain originating from the facet joints. Treatment is mainly conservative, although interventions, including intraarticular injections and medial branch nerve blocks are used to manage facet-mediated pain. Several studies have evaluated the effectiveness of these interventions. Results of facet joint injection, however, are conflicting.
Methods. Sixty subjects with diagnosis of facet joint syndrome were enrolled in the study. They were randomized into experimental and control groups. The experimental group was submitted to intraarticular injection of six lumbar facet joints with triamcinolone hexacetonide; the control group was submitted to triamcinolone acetonide intramuscular injection of six lumbar paravertebral points. Visits were taken at baseline and at 1, 4, 12 and 24 weeks after interventions. Outcome measures were used: pain visual analogical scale, pain visual analogical scale during extension of the spine, Likert scale, improvement percentage scale, Rolland-Morris, short health survey (SF36), accountability of medications taken.
Homogeneity was tested using Student's T, Pearson's Chi- Square and Mann-Whitney tests. ANOVA was used to analyze differences in the groups over time and the Student's t-test to analyze differences between groups at each time evaluation.
Results. The groups were similar at baseline. Comparisons between the groups showed, in ANOVA analysis, an improvement in the experimental group regarding diclofenac intake and quality of life, in the "role physical" profile, assessed by SF-36.
In the analysis at each time point, an improvement in the experimental group was also found in Rolland Morris, in the improvement percentage scale and in the response to treatment, assessed by the Likert scale.
Conclusion. Both treatments were effective, with a slightly superiority of the intraarticular injection of steroids over intramuscular injection.
