Effect of Ultrasound-guided Lumbar Medial Branch Block in Chronic Low Back Pain

Moon, Sang Ho; Lee, Song; Kim, Kwang Hai; Lee, Han Sol; Roh, Jang Ho; Kim, Jeeh Yong; Jung, Woo Sik

Abstract

PURPOSE
To examine the use of ultrasound as an alternative imaging technique to block lumbar medial branches in chronic low back pain.
MATERIALS AND METHODS
From August 2011 to September 2012, 27 patients with lumbar facet joint syndrome diagnosed by strict inclusion criteria among chronic low back pain patients have undergone medial branch block. All procedures have been performed by the same operator, and 23G, 10cm needle was placed and 0.5% lidocine was injected under ultrasound guide. To target medial branches from L1 to L5, the groove at the root of transverse process and the base of superior articular process has been identified on transverse scan. Patients were followed up by Visual Analog Scale and Oswestry Disability Index at 1 week after medial branch block.
RESULTS
VAS showed that preprocedure pain(7.0+/-1.4; mean+/-SD) significantly decreased after block(1.8+/-1.6)(p=0.0000). ODI also showed that preprocedure score(30.3+/-6.4) significantly decreased(9.0+/-7.7)(p=0.0000). Analysis of patient-reported pain and functional scores measured with VAS and ODI showed definite improvements after ultrasound-guided medial branch block. There was one complication of dizziness and weakness in both lower extremities immediate after procedure.
CONCLUSION
Ultrasound guidance offers a reliable alternative to fluoroscopy or computed tomography for lumbar medial branch blocks and can be safely performed without radiation exposure.