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Master Thesis

Le syndrome facettaire : du diagnostic à la prise en charge thérapeutique

Abstract : Facet joint (FJ) syndrome is accounting for 27-40% of low back pain (LBP) ans is a major socio-economic burden. Physical examination has limited or no diagnostic validity and radiological investigations, provide poor correlations between clinical symptoms and degenerative spinal changes. FJ local anesthesia and steroids infiltrations, are useful for diagnosis and treatment. FJ neurolysis may be proposed in case of a block effect, with significant pain relief. The present study was conducted to compare short and mid term (15 days and one month) efficacy of Pericpsular (PC) and Medial branch (MB) infiltrations on pain relief. PC infiltrations provide a higher short and mid term efficacy than MB infiltrations on a numerical pain scale. Otherwise, we report similar efficacy in both groups for block test. The target of an infiltration should therefore be decided depending on the goal of the procedure. On one hand, MB infiltrations are still the best approach in the ability to select patients for neurolysis. On the other hand, PC infiltrations allow a better midterm pain relief and should be used in low back pain management. The role of the radiologist is critical to manage low back pain diagnosis and treatment and radiologists’ should master facet joint pain management, from diagnosis, given by high performance imaging modalities, to interventional procedure. The radiologist should therefore play an active role in the difficult task of alleviating patients from chronic low back pain of facet join origin.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01825832
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Submitted on : Thursday, June 28, 2018 - 4:11:22 PM
Last modification on : Wednesday, July 15, 2020 - 8:58:04 AM
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  • HAL Id : dumas-01825832, version 1

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Romain Perolat. Le syndrome facettaire : du diagnostic à la prise en charge thérapeutique. Médecine humaine et pathologie. 2018. ⟨dumas-01825832⟩

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