Ultrasound-Guided Lumbar Peri-Facet Joint Blocks: A Therapuetuic Approach to Chronic Lower Back and Referred Leg Pain Management

Abstract

Intra-articular fluoroscopically-guided facet joint (FJ) blocks are performed with diagnostic-therapeutic aims, whereas the main focus of ultrasound guided peri-facet joint blocks (USG-PFJB) is pain relief. USG-PFJB will therefore typically utilize higher injection volumes to potentially offer injection spread to other pain-generating structures. This study explores the potential role of USG-PFJBs in the outpatient management of chronic low back pain with our without leg symptoms in patients with MRI-confirmed mild to severe lower lumbar FJ arthrosis. USG-PFJBs were performed on 19 patients, (4 male and 15 females, mean age 55) at the L4/5 and/or L5/S1 segments at paraspinal points of palpable focal pain. All procedures were performed by the same clinician. One patient was lost to follow up and telephone reviews at 2-6 months on the remaining 18 patients, noted that 59.73% experienced significant & sustained pain relief.  In conclusion, lower lumbar segment USG-PFJBs appear to be effective treatment option in patients with mild to severe MRI-confirmed FJ degeneration and palpable paraspinal lower back pain and with or without lower limb pain.