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

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. DESIGN:Retrospective case series with independent follow-up. SETTING:Institutional, referral center. 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. 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. MAIN OUTCOME MEASURES:Patient satisfaction, and whether or not surgery was performed. 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. 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.

journal_name

Arch Phys Med Rehabil

authors

Sabers SR,Ross SR,Grogg BE,Lauder TD

doi

10.1016/j.apmr.2004.11.051

subject

Has Abstract

pub_date

2005-09-01 00:00:00

pages

1767-71

issue

9

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(05)00396-5

journal_volume

86

pub_type

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