gms | German Medical Science

54. Jahrestagung der Norddeutschen Orthopädenvereinigung e. V.

Norddeutsche Orthopädenvereinigung

16.06. bis 18.06.2005, Hamburg

Validation of fluoroscopically controlled lumbar facet joint injection using oblique needle technique in degenerative lumbar spine syndrome.

Meeting Abstract

  • corresponding author U. Schütz - University of Ulm, (c/o Rehabilitationskrankenhaus Ulm), Orthopädie, Ulm
  • M. Richter - Wiesbaden
  • K.E. Dreinhöfer - Ulm
  • W. Puhl - Ulm
  • H. Koepp - Ulm

Norddeutsche Orthopädenvereinigung. 54. Jahrestagung der Norddeutschen Orthopädenvereinigung e.V.. Hamburg, 16.-18.06.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05novP23

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Veröffentlicht: 13. Juni 2005

© 2005 Schütz et al.
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Is the fluoroscopically controlled lumbar facet joint injection (FJI) with local anesthetics a suitable procedure for preoperative diagnosis of symptomatic degenerative facet joint (FJ) disease?

60 patients with degenerative lumbar spine syndrome and radiographic FJ-osteoarthritis (L4/5:29, L5/S1:31) were injected 3 times according to a single blinded randomised trial on one segmental level bilateraly: verum (1.5ml 0.5%-scandicaine), placebo (1.5ml 0.9% sodium-chloride) and with no fluid volume (sicca). Pain level before and after FJI (30,60,150min.) was noted by the patient on a 10pts.-VAS. If pain relief occurs after a FJI, the patient is defined as responder. A responder reacts false positive if the degree of effectiveness of the placebo-FJI is the same or better than the response to LA. A patient reacts false negative if the pain diminution after LA application is lower than after placebo.

30min (60min) after FJI 18% (9%) were non-responder and 51% (70%) verum-responder. The responder-rate for sicca was 44% (47%), for placebo 46% (56%). 32% (21%) reacted false positive after sicca, after placebo it were 25% (19%). False negative reactions after verum could be found in 33% (44%), therefor 26% (32%) compared to placebo and 19% (26%) compared to sicca.

Despite numerous examinations sufficient detection of accurate reliable predictors for positive FJI-responders was not possible till now. This is confirmed by our high non-responder-rate. Placebo responses seem to be highly common. Regarding the criterias specifity and sensitivity, our results indicate, that the only one times diagnostic FJI for verification of a FJ-syndrome has to be declined.