Clinical features of patients with pain stemming from the lumbar zygapophysial joints. Is the lumbar facet syndrome a clinical entity?
Schwarzer, A.C.; Aprill, C.N.; Derby, R.; Fortin, J.; Kine, G.; Bogduk, N.
Spine 19(10): 1132-1137
1994
ISSN/ISBN: 0362-2436 PMID: 8059268 Document Number: 428173
Study Design: This study is a prospective cross-sectional analytic study. Objectives: The authors determined the prevalence and clinical features of patients with pain stemming from the lumbar zygapophysial joints. Summary of Background Data: Previous studies have demonstrated a wide range of prevalence for zygapophysial joint pain and conflicting results with regard to clinical signs. Methods: One hundred and seventy-six consecutive patients with chronic low back pain were investigated with a series of screening zygapophysial joint blocks using lignocaine and confirmatory blocks using bupivacaine. Results: Forty-seven percent of patients had a definite or greater response to the screening injection at one or more levels but only 15% had a 50% or greater response to a confirmatory block. Response to zygapophysial joint injection was not associated with any single clinical feature or set of clinical features. Conclusions: The zygapophysial joint is an important source of pain but the existence of a "facet syndrome" must be questioned.