Facet joint injection versus epidural steroid injection for lumbar spinal stenosis: intra-individual study

• Published in: Clinical radiology 2017-01, Vol.72 (1), p.96.e7-96.e14
• Main Authors: Shim, E, Lee, J.W, Lee, E, Im, T, Kang, Y, Ahn, J.M, Kang, H.S
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Female; Humans; Injections, Epidural - methods; Injections, Intra-Articular - methods; Low Back Pain - diagnosis; Low Back Pain - drug therapy; Low Back Pain - etiology; Male; Middle Aged; Pregnancy; Radiography, Interventional - methods; Radiology; Retrospective Studies; Spinal Stenosis - complications; Spinal Stenosis - diagnostic imaging; Spinal Stenosis - drug therapy; Steroids - administration & dosage; Treatment Outcome; Zygapophyseal Joint - diagnostic imaging; Zygapophyseal Joint - drug effects
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2016.08.006

Aim To evaluate the efficacy of facet joint injection (FJI) for patients with lumbar central canal stenosis (LCS) in comparison with epidural steroid injection (ESI) in the same individuals. Material and methods Two hundred and fifty-two patients who underwent both FJI and ESI for LCS between January 2014 and December 2014 were considered for enrolment in the study. A radiologist retrospectively conducted a chart review and recorded which injection was chosen as the third injection after sequential injections of FJI and ESI, and why clinicians chose the particular injection method. The response was measured via the use of a five-point satisfaction scale. Results Among 252 patients, only 73 patients were included in the study (the remaining patients did not fulfil the inclusion criteria). Out of 73 patients (mean age, 69.7 years; range, 49∼87 years), 50 patients had received a third injection, 33 patients (66%) underwent FJIs as a third injection. Out of 19 patients who had experienced an ineffective first ESI, 13 (68.4%) patients reported the second FJI as effective. Out of six patients for whom the first FJI had been ineffective, three (50%) patients reported the second ESI as effective. Conclusion FJIs can be administered as an alternative to ESIs in cases of LCS.