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Tables for:
Indications for and Benefits of Lumbar Facet Joint Block

[Neurosurg Focus 13(2), 2002. © 2002 American Association of Neurological Surgeons]


Table 1. Spinal levels treated with block


LevelUnilat (%)Bilat (%)
L5-S159 (25.7)44 (19.1)
L4-549 (21.3)14 (6)
L3-412 (5.2) 
more levels52 (22.6) 

Table 2. Outcome according to patient-rated responses


Outcome
Category
No. of
Patients (%)
Criteria
excellent43 (18.7)complete relief of back & lower-extremity
   pain; no further analgesics necessary; no
   pain during follow up of 6-12 mos
good27 (11.7)disappearance of lower-extremity pain, but
   not low-back pain; mild analgesics used
fair44 (19.1)only partial relief of low-back pain and
   lower-extremity pain
poor116 (50.4)no relief, unable to work; strong analgesic
   used regularly

Table 3. Summary of complications in 22 patients


ComplicationsNo. of
Patients
Reaction
wrong level injected8injection repeated
transient increase of pain6no specific therapy
puncture of subarachnoid space3no specific therapy
severe pain2interruption
transient hypesthesia2no therapy
transient paraplegia1no therapy

Table 4. Summary of data in 116 patients in whom symptoms did not respond to facet joint injections


Signs & SymptomsNo. of
Patients
W/Out
Response
CT or MR
Finding
ConclusionPain
Improvement
chronic back pain w/ or w/out radiation (> 1 yr)44degenerative changes, no disc prolapse, no spinal canal stenosisconservative therapynone
chronic postdiscectomy syndrome37scar tissue & in 7 recurrent disc prolapse7 reop5 improved
spinal canal stenosis29spinal canal stenosislaminotomy & osseous decompression19 w/good results, 2 w/no improvement
acute pain after percutaneous nucleotomy6no disc prolapse, no signs of disc prolapsewrong indication (nerve root injury?)none

Table 5. Questionable responses to injection therapy in 28 patients


IndicationNo. of
Patients
CT or MR FindingLevel InjectedComment
unspecific back pain9multisegmental lumbar facet joint degenerationL3-4, L4-5, & L5-S1 bilaterallyvery unpleasant, short improvement
pain after multiple disc ops (> 4)4scar tissue, degenerative disc spaceop levelno improvement
analgesic addiction after multiple disc ops4no recurrent disc prolapseop levelno improvement
pain after percutaneous neucleotomy4protrusion, no neural compressionop level2 no improvement, 1 op interrupted due to pain
extreme obesity w/low-back pain7severe lumbar degenerative changesL3-4, L4-5, & L5-S1 bilaterallyvery unpleasant, 2 short improvement, 2 no improvement