• Spine · Oct 2023

    Review

    Predictors of Outcomes Following Lumbar Intra-articular Facet Joint Injections and Medial Branch Blocks: A Scoping Review.

    • José I Acosta Julbe, Jacob C Mandell, Joerg Ermann, Zacharia Isaac, Julia R Gottreich, Jay M Zampini, Miriam DeFilipp, Michael N Andrew, and Jeffrey N Katz.
    • Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
    • Spine. 2023 Oct 15; 48 (20): 145514631455-1463.

    Study DesignA scoping review.ObjectiveWe aimed to identify and describe the factors associated with the patient-reported response after lumbar intra-articular facet joint (FJ) injections or medial branch blocks (MBBs).Summary Of Background DataFJ osteoarthritis is among the most common causes of chronic low back pain. Management often includes FJ intra-articular injection and MBBs (which may be followed by radiofrequency ablation of the nerves innervating these joints). However, the success of these approaches is variable, prompting interest in identifying patient characteristics (imaging features, clinical signs, and among others) associated with response to these types of facet injections.Materials And MethodsWe performed a literature search on factors associated with patient-reported outcomes after lumbar FJ intra-articular injections or MBBs for patients with low back pain published in English or Spanish between 2000 and 2023. We excluded duplicate papers that did not describe factors associated with outcomes or those describing other interventions. We collected data on the association of these factors with patient-reported outcomes.ResultsThirty-seven studies met the inclusion criteria and were analyzed. These studies evaluated factors, such as age, depression, and single photon emission computed tomography (SPECT), and among variables. Age and imaging findings of facet arthropathy were the most frequently described factors. Imaging findings of FJ arthropathy and positive SPECT were often associated with positive results after intra-articular FJ injections or MBBs. In contrast, younger age and smoking were frequently associated with less favorable clinical outcomes.ConclusionNumerous factors were considered in the 37 studies included in this review. Imaging findings of facet arthropathy, duration of pain, and positive SPECT were consistently associated with favorable results after facet interventions.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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