Image-guided injections for facet joint pain: evidence-based Delphi conjoined consensus paper from the European Society of Musculoskeletal Radiology and European Society of Neuroradiology - Summary - MDSpire

Image-guided injections for facet joint pain: evidence-based Delphi conjoined consensus paper from the European Society of Musculoskeletal Radiology and European Society of Neuroradiology

  • By

  • Luca Maria Sconfienza

  • Danoob Dalili

  • Miraude Adriaensen

  • Domenico Albano

  • Georgina Allen

  • Maria Pilar Aparisi Gomez

  • Giacomo Aringhieri

  • Francesco Arrigoni

  • Alberto Bazzocchi

  • Miguel Oliveira Castro

  • Roberto Luigi Cazzato

  • Miriam De Dea

  • Aldo Eros De Vivo

  • Elena Drakonaki

  • Fernando Facal de Castro

  • Dimitrios Filippiadis

  • Jan Fritz

  • Inês Gil

  • Salvatore Gitto

  • Hannes Gruber

  • Harun Gupta

  • Amanda Isaac

  • Andrea S. Klauser

  • Thomas Le Corroller

  • Alexander Loizides

  • Salvatore Marsico

  • Giovanni Mauri

  • Eugene McNally

  • Kalliopi Melaki

  • Carmelo Messina

  • Rebeca Mirón Mombiela

  • Cyprian Olchowy

  • Davide Orlandi

  • Ricardo Moutinho

  • Riccardo Picasso

  • Mahesh Prakash

  • Nicolas Theumann

  • Violeta Vasilevska Nikodinovska

  • Evangelia E. Vassalou

  • Jelena Vucetic

  • David Wilson

  • Federico Zaottini

  • Marcello Zappia

  • Chiara Zini

  • Žiga Snoj

  • May 8, 2025

  • 0 min

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Objective:

To assess the evidence on image-guided injections for treating facet joint pain and to develop evidence-based clinical indications that can guide clinical practice.

Key Findings:
  • US-guided injections yield better outcomes than blind injections for lumbar facet joint pain, as evidenced by improved clinical outcomes in a randomized controlled trial.
  • Medial branch block with local anesthetic and corticosteroid shows similar outcomes to local anesthetic only, indicating effective pain management strategies.
  • US-guided injections of methylene blue and lidocaine are safe and effective for lumbar facet joint pain, with significant benefits observed at 3 and 6 months.
  • US-guided cervical medial branch blocks are quicker and require fewer needle passes than fluoroscopy-guided, enhancing procedural efficiency.
  • No clinical outcome differences were found between US-guided, fluoroscopy-guided, and CT-guided cervical injections, suggesting comparable efficacy across methods.
  • The lateral US-guided approach is more accurate than the posterior approach for cervical facet joint injections, improving procedural precision.
  • No differences in outcomes between thoracic facet joint injections and medial branch blocks under fluoroscopy guidance, indicating consistent effectiveness.
  • No significant time duration differences were observed among US-guided, fluoroscopy-guided, and CT-guided lumbar procedures, suggesting similar procedural times.
Interpretation:

Image-guided injections, particularly using ultrasound, provide effective and safer options for managing facet joint pain, with evidence supporting their use over traditional methods, which may influence treatment protocols.

Limitations:
  • The long-term outcomes of US-guided injections remain unknown, highlighting a gap in the current evidence base.
  • Variability in procedure time definitions and measurements across studies may affect comparisons, suggesting a need for standardized reporting.
Conclusion:

The consensus paper provides a comprehensive overview of the efficacy and safety of image-guided injections for facet joint pain, emphasizing the advantages of ultrasound guidance and its potential impact on clinical practice.

Original Source(s)

Image-guided injections for facet joint pain: evidence-based Delphi conjoined consensus paper from the European Society of Musculoskeletal Radiology and European Society of Neuroradiology

  • by Luca Maria Sconfienza, Danoob Dalili, Miraude Adriaensen, Domenico Albano, Georgina Allen, Maria Pilar Aparisi Gomez, Giacomo Aringhieri, Francesco Arrigoni, Alberto Bazzocchi, Miguel Oliveira Castro, Roberto Luigi Cazzato, Miriam De Dea, Aldo Eros De Vivo, Elena Drakonaki, Fernando Facal de Castro, Dimitrios Filippiadis, Jan Fritz, Inês Gil, Salvatore Gitto, Hannes Gruber, Harun Gupta, Amanda Isaac, Andrea S. Klauser, Thomas Le Corroller, Alexander Loizides, Salvatore Marsico, Giovanni Mauri, Eugene McNally, Kalliopi Melaki, Carmelo Messina, Rebeca Mirón Mombiela, Cyprian Olchowy, Davide Orlandi, Ricardo Moutinho, Riccardo Picasso, Mahesh Prakash, Nicolas Theumann, Violeta Vasilevska Nikodinovska, Evangelia E. Vassalou, Jelena Vucetic, David Wilson, Federico Zaottini, Marcello Zappia, Chiara Zini, Žiga Snoj

  • May 8, 2025

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