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Back pain, mechanical musculoskeletal problems, local soft tissue disorders
SAT0524 Comparison of Ultrasonography-Guided Injection with Blind Injection in Facet Syndrome; A 6-Week Randomized Controlled Trial
  1. M. Karkucak1,
  2. I. Batmaz2,
  3. S. Kerimoglu3,
  4. A. Ayar4
  1. 1Department of Physical and Rehabilitation Medicine, Karadeniz Technical University, Medical school, Trabzon
  2. 2Department of Physical and Rehabilitation Medicine, Dicle University, Medical School, Diyarbakır
  3. 3Department of Orthopedics and Traumatology
  4. 4Department of Physiology, Medical School, Karadeniz Technical University, Medical school, Trabzon, Turkey

Abstract

Background Local injection is a good alternative medical treatment in soft tissue disorders. Ultrasonography (US) is a good guide for local applications which increases the efficacy of the treatment.

Objectives To compare the local injection performed by US-guided with blind injection in facet syndrome

Methods Forty seven patients with the diagnosis of facet syndrome were included in the study.Patients were randomized into two groups. The patient's history, physical examination and routine laboratory parameters were used to diagnosis of facet syndrome.

Inclusion criteria for the study were as follows: pain for at least 6 weeks, pain extending to gluteal region and thigh, presence of pain with lumbar hyperextension and lateral flexion, paravertebral tenderness at the facet joint localization, negative straight leg raising test and normal neurological examination findings.

Approximately 5 cc of injection solution which was a mixture of 1–2% lidocaine hydrochloride and triamcinolone was applied twice within 15 days to maximum 2 points most tender with palpation (bilateral; L4–5 or L5-S1, unilateral; L4–5 and L5-S1). Assessment was made within 0, 2 and 6 weeks with Visual analog scale (VAS), Modified Oswestry scale and State-Trait Anxiety Inventory.

Results The patients' initial VAS and Oswestry scale scores were similar. When the two groups were compared at the 6th week in terms of VAS scores, improvement was more pronounced in US-guided injection group (US-guided group before 7.6±2.2, after 3.0±1.7, p=0.000 vs blind group before 7.2±1.3, after 5.2±2.0, p=0.000). According to Oswestry scale scores at the 6th week there was no statistically significant difference between the two groups. The improvement in initial and 6th week Oswestry scale scores was statistically significant in the US-guided injection group (p=0.006). The improvement in trait anxiety scale scores was significant in both groups.

Conclusions The US-guided local injections used in the treatment of facet syndrome have positive impact on both pain and functions.

Disclosure of Interest None declared

https://doi.org/10.1136/annrheumdis-2016-eular.2644

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