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Procedure-based nonsurgical management of lumbar zygapophyseal joint cyst-induced radicular pain.
- 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.
- Subjects :
- Adult
Aged
Aged, 80 and over
Biopsy, Fine-Needle
Combined Modality Therapy
Female
Humans
Injections, Epidural
Low Back Pain etiology
Male
Middle Aged
Pain Measurement
Prognosis
Radiculopathy diagnosis
Radiculopathy etiology
Range of Motion, Articular physiology
Retrospective Studies
Risk Assessment
Synovial Cyst complications
Synovial Cyst diagnosis
Treatment Outcome
Low Back Pain therapy
Lumbar Vertebrae
Radiculopathy therapy
Steroids administration & dosage
Synovial Cyst therapy
Zygapophyseal Joint physiopathology
Subjects
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