Woo Young Kang1, Joon Woo Lee2, Eugene Lee3, Yusuhn Kang3, Joong Mo Ahn3, Heung Sik Kang3. 1. Department of Radiology, Chungbuk National University Hospital, Cheongju, South Korea. 2. Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea. joonwoo2@gmail.com. 3. Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea.
Abstract
OBJECTIVE: To assess the efficacy of fluoroscopy-guided facet joint injection for symptomatic spondylolysis and to analyze the outcome predictors. MATERIALS AND METHODS: This study included 108 patients who underwent fluoroscopy-guided facet joint steroid injection for symptomatic spondylolysis with follow-up medical records from January 2013 to December 2016. Among them, 47 patients underwent concomitant epidural steroid injection. Response to injection was assessed at the initial follow-up. The symptom-free interval was analyzed using the Kaplan-Meier method. Outcome predictors were statistically analyzed using independent t test and Chi-square test. RESULTS: The facet joint injection was effective in 52 of 108 (48.1%) patients at initial follow-up. Recurrence was reported in 21 of these 52 (40.4%) patients. For the 52 patients in whom facet joint injection was effective, the median symptom-free interval was 298 days (95% confidence interval, 29-567 days). No significant difference was found in the response between the group with facet joint injection only (n = 61) and the group with facet joint injection and additional ESI (n = 47). Additionally, no significant outcome predictors were detected. CONCLUSIONS: Fluoroscopy-guided facet joint injection may potentially be an effective therapy for providing prolonged pain relief and avoiding unnecessary surgery for symptomatic spondylolysis without significant outcome predictors.
OBJECTIVE: To assess the efficacy of fluoroscopy-guided facet joint injection for symptomatic spondylolysis and to analyze the outcome predictors. MATERIALS AND METHODS: This study included 108 patients who underwent fluoroscopy-guided facet joint steroid injection for symptomatic spondylolysis with follow-up medical records from January 2013 to December 2016. Among them, 47 patients underwent concomitant epidural steroid injection. Response to injection was assessed at the initial follow-up. The symptom-free interval was analyzed using the Kaplan-Meier method. Outcome predictors were statistically analyzed using independent t test and Chi-square test. RESULTS: The facet joint injection was effective in 52 of 108 (48.1%) patients at initial follow-up. Recurrence was reported in 21 of these 52 (40.4%) patients. For the 52 patients in whom facet joint injection was effective, the median symptom-free interval was 298 days (95% confidence interval, 29-567 days). No significant difference was found in the response between the group with facet joint injection only (n = 61) and the group with facet joint injection and additional ESI (n = 47). Additionally, no significant outcome predictors were detected. CONCLUSIONS: Fluoroscopy-guided facet joint injection may potentially be an effective therapy for providing prolonged pain relief and avoiding unnecessary surgery for symptomatic spondylolysis without significant outcome predictors.
Authors: John T Wald; Jennifer R Geske; Felix E Diehn; Naveen S Murthy; Timothy J Kaufmann; Kent R Thielen; Jonathan M Morris; Vance T Lehman; Vance Lehman; Timothy P Maus Journal: Pain Med Date: 2014-01-21 Impact factor: 3.750