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Facet joint injections with and without endplate damage—a prospective cohort study.

Endplate Damage

Goal of the Study?

Lower back pain contributes to a lot of pain and disability on this planet. One of the strategies for dealing with it is using facet joint injections with corticosteroids to reduce the pain. However, facet joint injections do not always work. In this prospective cohort study published in The Spine Journal1 these researchers questioned whether having another finding, namely, endplate damage, along with facet joint degeneration, could alter the outcome when using facet joint injections as a therapeutic approach.

 

Why are they doing this study?

These authors were curious whether having both endplate changes and facet joint degeneration gave a poorer outcome for facet joint injections compared to having only facet joint degeneration alone.

What was done?

In this prospective cohort study, all low back pain subjects underwent PET/MRI and conventional MRI to determine which of the 42  had endplate damage and facet joint degeneration. All subjects were treated with facet joint injections. Outcomes were measured using the conventional graphical numerical 0-10 point pain scale.

 

What did they find?

Facet joint degeneration is a common cause of lower back pain with the strategy to relieve it using corticosteroid injections. However, in this study, they found that subjects with BOTH facet joint degeneration AND endplate damage did not respond as well compared to those with only facet joint degeneration alone.

 

Why do these findings matter?

In selecting who may benefit from facet joint injections, these findings matter because they highlight that those who have endplate damage and facet degeneration may not benefit as much. This important finding should be considered when realistic outcomes are shared with low back pain patients.

 

At Dynamic Disc Designs, we have human anatomy models of both facet joint degeneration and endplate damage when going over potential treatment strategies with patients seeking out care for their lower back pain. Our patient education models are dynamic and realistic to help spine professionals in their clinical consults.

 

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