Facet Joint Pain Clinical Trial
Official title:
Comparison of Facet Nerve Block Versus Intra-articular Injection in the Diagnosis and Treatment of Lumbar Facet Syndrome
In suspected facet joints pain, it is recommended to perform nerve blocks to establish the diagnosis with positive results being and indicator of successful of most permanent treatment of facet pain by rhizolysis. Nevertheless, the usefulness of intraarticular joint injection for diagnosis and prediction of successful neurolysis have been scarcely studied. The main purpose of this trial is to compare both methods, nerve block and intra articular injection, in diagnosis and treatment of facet joints pain.
Facet joint pain is considered as a nonspecific cause of spinal pain with an estimated
prevalence of 12-61% of the population. At present, there are no unanimous clinical criteria
to achieve and accurate diagnosis and the imaging findings do not show a direct correlation
with the clinical symptoms.
Facet syndrome treatment is also controversial and, although most clinical guidelines
recommend nerve block as a diagnostic test, followed by neurolysis as therapeutic technique,
there are many detractors of this therapeutic sequence.
The confusion is even greater when considering the variability of specialists who perform
these techniques, the variability of methods used ranging from blind injections to injections
guided by ultrasound, fluoroscopy or CT, or the amount of medication injected.
The investigators have long experience in the percutaneous treatment of pain and in the use
of different imaging techniques. Although the investigators objectives are multiple, the main
one is to know if there are any difference in the outcome of the facet syndrome treated by
intra-articular injections and the block of the medial branch of the dorsal branch of the
spinal nerve.
Along with the collaboration of other specialists the investigators want to address secondary
objectives such as the usefulness of ultrasound and fluoroscopy in the treatment of facet
syndrome and its comparison with those performed under CT guidance that is considered as the
standard technique for its greater precision.
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