Artikel
Combined facet nerve blocks and gabapentin provide long term relief from chronic lumbar facet arthritis pain
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Veröffentlicht: | 13. Oktober 2014 |
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Gliederung
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Purpose: To evaluate the efficacy of combined therapy of chronic lumbar facet arthritis pain, with lumbar facet nerve blocks (rupivacaine/cortisone) and gabapentin.
Methods/subjects: In a controlled randomized double blind study, 142 patients suffering from lumbar facet arthritis pain, were randomly assigned to receive either lumbar facet joint nerve blocks with rupivacaine/cortisone and gabapentin administrated orally (1200 mg daily) for 2 months (Group 1, n=71 patients) or gapabentin alone (Group 2, n=71 patients).
Clinical outcomes were measured with VAS pain scale and Roland-Morris Disability Questionnaire at baseline, 6 months, 1 and 2 years after the end of therapy. All patients underwent MRI of lumbar spine to establish facet joint arthritis and to exclude other lesions. Each patient received totally 5 injections (1/10 days). Statistical analysis was performed by statistical packet STATA 8.0 and significance was set at p-value <0.05.
Results: Nine patients finally excluded from the study. The VAS pain score decreased significantly from 8.4/10 to 3.8/10 in Group 1 (P<0.05) and from 8.2/10 to 6.8/10 in Group 2 (p>0.05) at 2 years follow up. Roland Morris Disability decreased also significantly from average 15.1/24 to 3.3/24 in Group 1 (p<0.05) and from 15.3/24 to 9.6/24 in Group 2 (p>0.05) at 2 years follow up. Better clinical outcomes were observed in Group 1 (p<0.05).
Conclusion: Combined therapy consisted of lumbar facet joint nerve blocks with rupivacaine and cortisone associated with pregabalin provide long term efficient pain relief in patients suffering from lumbar facet arthritis.