19 Harley St, London, W1G 9QJ, UK

Predictability of the effects of facet joint infiltration in the degenerate lumbar spine when assessing MRI scans.

Predictability of the effects of facet joint infiltration in the degenerate lumbar spine when assessing MRI scans.

J Orthop Surg Res. 2017 Nov 21;12(1):180

Authors: Hofmann UK, Keller RL, Walter C, Mittag F

BACKGROUND: Imaging results are frequently considered as hallmarks of disease by spine surgeons to plan their future treatment strategy. Numerous classification systems have been proposed to quantify or grade lumbar magnetic resonance imaging (MRI) scans and thus objectify imaging findings. The clinical impact of the measured parameters remains, however, unclear. To evaluate the pathological significance of imaging findings in patients with multisegmental degenerative findings, clinicians can perform image-guided local infiltrations to target defined areas such as the facet joints. The aim of the present retrospective study was to evaluate the correlation of MRI facet joint degeneration and spinal stenosis measurements with improvement obtained by image-guided intraarticular facet joint infiltration.
METHODS: Fifty MRI scans of patients with chronic lumbar back pain were graded radiologically using a wide range of classification and measurement systems. The reported effect of facet joint injections at the site was recorded, and a comparative analysis performed.
RESULTS: When we allocated patients according to their reported pain relief, 27 showed no improvement (0-30%), 16 reported good improvement (31-75%) and 7 reported excellent improvement (>?75%). MRI features assessed in this study did, however, not show any relevant correlation with reported pain after facet joint infiltration: Values for Kendall’s tau ranged from ??=?-?0.190 for neuroforaminal stenosis grading as suggested by Lee, to ??=?0.133 for posterior disc height as proposed by Hasegawa.
CONCLUSION: Despite the trend in evidence-based medicine to provide medical algorithms, our findings underline the continuing need for individualised spine care that, along with imaging techniques or targeted infiltrations, includes diagnostic dimensions such as good patient history and clinical examination to formulate a diagnosis.
TRIAL REGISTRATION: , NCT03308149 , retrospectively registered October 2017.

PMID: 29162138 [PubMed – in process]

Share to care...

Share on facebook
Share on twitter
Share on pinterest
Share on google
Share on linkedin
Share on skype

What we do...

The Harley Street Hospital


What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

We treat all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

What our patients say about us ......