• Raj Mitra, Huy Do, Todd Alamin, and Ivan Cheng.
• Stanford School of Medicine, Physical Medicine and Rehabilitation, Redwood City, California 940663, USA. rmitra@stanford.edu
• Pain Med. 2010 Nov 1; 11 (11): 1674-7.

ObjectiveTo determine if thoracic facet joints may be a significant secondary pain generator in patients with compression fractures. Traditionally, pain from vertebral compression fractures has been attributed to vertebral body itself. Compression fractures have been shown to increase thoracic kyphosis and thereby increase the thoracic flexion moment; these changes eventually increase the shear stress on the posterior elements.DesignWe present a small case series of patients with thoracic compression fractures managed with intra-articular facet injections.SettingTertiary care academic medical center.ParticipantsTwo patients with thoracic compression fractures.InterventionsThe subjects received fluoroscopically guided thoracic facet steroid injections for pain management.Main OutcomeChange in verbal analog pain score.ResultsPatients with thoracic compression fractures received significant long-lasting relief after receiving fluoroscopically guided intra-articular injections.ConclusionFacet joints may be abnormally stressed due to the increasing thoracic flexion moment in anterior compression fractures, which may serve as a secondary pain generator; intra-articular facet blocks may be an alternative to vertebroplasty.Wiley Periodicals, Inc.

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