Efficacy of facet joints blockade at patients with lumbar osteochondrosis

Objective. To analyze the efficacy of two types blockade in the treatment of facet syndrome at patients with lumbar osteochondrosis.

Material and methods. The analysis of treatment outcomes at 70 patients with facet syndrome because of lumbar osteochondrosis was performed. Mean age was 61 years old (from 47 till 84 years old),  men were 11, female patients — 59. Exclusion criteria were radicular symptoms, neurogenic intermittent claudication, compression of neural structures according to MRI data, spondylolisthesis,  vertebral instability according to X-ray examination. Diagnosis of  facet syndrome was done based on positive effect of diagnostic  blockade of damaged facet joint. Further we performed the  medicative blockade of relevant facet joint. All patients were divided  into 2 groups accordingly to type of medicative blockade. Patients underwent blockade with Kenalog were included in 1st group (n=40) and patients underwent blockade with alcohol and  lidocaine — 2d group (n=30). The severity of pain syndrome was  estimated in scores using Visual Analogue Scale (VAS). Dynamics of  pain syndrome was evaluated in 2 days after blockade and in 3, 6 and 12 months after procedure.

Results. The mean intensity of pain syndrome before blockade was 7,5 scores in 1st group and 7,2 scores in 2d group. The mean  intensity of pain syndrome in 2 days after medicated blockade was  2,3 in 1st group and 2 scores in 2d group. The mean intensity of  pain syndrome in 3 months after medicated blockade was 2,5 in 1st  group and 2,2 scores in 2d group. The mean intensity of pain  syndrome in 6 months after medicated blockade was 4,8 in 1st  group and 3,3 scores in 2d group. The mean intensity of pain  syndrome in 12 months after medicated blockade was 5,3 in 1st group and 4,6 scores in 2d group. Minima pain syndrome (1-2 scores) in 12 months after blockade was seen at 17,5% (n=7) patients in 1st group and at 20% (n=7) patients of 2d group (n=7).

Conclusion. The usage of facet joints blockade is effective method for pain relief at patients with facet syndrome. The mean duration of  analgesic effect of blockade with usage of alcohol and Kenalog was 3 months and alcohol-lidocaine — 6 months

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