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Procedure-based nonsurgical management of lumbar zygapophyseal joint cyst-induced radicular pain.

Authors :
Sabers SR
Ross SR
Grogg BE
Lauder TD
Source :
Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2005 Sep; Vol. 86 (9), pp. 1767-71.
Publication Year :
2005

Abstract

Objective: To evaluate the success of fluoroscopically guided, contrast-enhanced lumbar zygapophyseal joint (Z-joint) aspiration and steroid injection combined with transforaminal epidural steroid injections (TFESIs) for the treatment of lumbar Z-joint cyst-induced radicular pain.<br />Design: Retrospective case series with independent follow-up.<br />Setting: Institutional, referral center.<br />Participants: Twenty-three patients referred to a single provider for procedure-based management of radicular pain believed secondary to lumbar Z-joint cyst. Inclusion criteria consisted of lumbar radicular pain that was consistent with the level and side of the Z-joint cyst as a causative lesion.<br />Interventions: Eighteen patients were treated with a fluoroscopically guided, contrast-enhanced Z-joint aspiration and steroid injection at the level of the causative cyst coupled with a fluoroscopically guided, contrast-enhanced TFESI over the level of the presumably irritated spinal nerve.<br />Main Outcome Measures: Patient satisfaction, and whether or not surgery was performed.<br />Results: Fifty percent of patients treated with the procedure had significant long-term benefit and avoided surgical intervention at an average follow-up of 9.9 months.<br />Conclusions: Fluoroscopically guided, contrast-enhanced spinal procedures as part of an aggressive nonsurgical treatment program are a safe and effective alternative to surgical intervention for lumbar Z-joint cyst-induced radicular pain.

Details

Language :
English
ISSN :
0003-9993
Volume :
86
Issue :
9
Database :
MEDLINE
Journal :
Archives of physical medicine and rehabilitation
Publication Type :
Academic Journal
Accession number :
16181940
Full Text :
https://doi.org/10.1016/j.apmr.2004.11.051