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Intra-articular facet joint injections for low back pain : a systematic review
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Vekaria, Rajni, Bhatt, Ree’thee, Ellard, David R., Henschke, Nicholas, Underwood, Martin and Sandhu, Harbinder (2016) Intra-articular facet joint injections for low back pain : a systematic review. European Spine Journal, 25 (4). pp. 1266-1281. doi:10.1007/s00586-016-4455-y ISSN 0940-6719.
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Official URL: http://dx.doi.org/10.1007/s00586-016-4455-y
Abstract
Purpose:
Evidence supporting the use of therapeutic intra-articular facet joint injections for patients with suspected facet joint pain is sparse. A systematic review including a narrative synthesis was carried out to determine if intra-articular facet joint injections with active drug are more effective in reducing back pain and back pain-related disability than a sham procedure or a placebo/inactive injection. Secondly, to determine if intra-articular facet joint injections with active drug or placebo/inactive injection are more effective in reducing back pain and back pain-related disability than conservative treatment.
Methods:
Medline, EMBASE, CINAHL, CENTRAL, Index to Chiropractic Literature and the Cochrane Central Register of Controlled Trials were searched from inception through April 2015. Data were screened and single extraction with independent verification and risk of bias assessment was performed.
Results:
A total of 391 records were screened, and six trials were included. The trials included were small (range 18–109 participants) and overall in terms of pain and disability outcomes most were inconclusive. Only two of the trials report any significant between-group differences in pain (mean difference −1.0, 95 % CI −2.0 to −0.1) and (p = 0.032) or disability (mean difference −3.0, 95 % CI −6.2 to 0.2) and (p = 0.013) outcomes.
Conclusions:
The studies found here were clinically diverse and precluded any meta-analysis. A number of methodological issues were identified. The positive results, whilst interpreted with caution, do suggest that there is a need for further high-quality work in this area.
Item Type: | Journal Article | ||||||||||
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Subjects: | R Medicine > RD Surgery | ||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Back -- Diseases -- Treatment, Backache, Injections, Systematic reviews (Medical research) | ||||||||||
Journal or Publication Title: | European Spine Journal | ||||||||||
Publisher: | Springer | ||||||||||
ISSN: | 0940-6719 | ||||||||||
Official Date: | April 2016 | ||||||||||
Dates: |
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Volume: | 25 | ||||||||||
Number: | 4 | ||||||||||
Page Range: | pp. 1266-1281 | ||||||||||
DOI: | 10.1007/s00586-016-4455-y | ||||||||||
Status: | Peer Reviewed | ||||||||||
Publication Status: | Published | ||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||
Date of first compliant deposit: | 25 January 2017 | ||||||||||
Date of first compliant Open Access: | 25 January 2017 | ||||||||||
Funder: | Birmingham Science City, Advantage West Midlands (AWM), National Institute for Health Research (Great Britain) (NIHR) | ||||||||||
Grant number: | HTA Project: 11/31/01—Facet Feasibility (NIHR) |
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