1. 2009;12;855-866Accuracy of Diagnostic Lumbar Facet Joint Nerve Blocks: A 2-Year Follow-Up of 152 Patients Diagnosed with Controlled Diagnostic Blocks
   Original Contribution
   Laxmaiah Manchikanti, MD, Kimberly A. Cash, RT, and Sneha Pampati, .

BACKGROUND: Lumbar facet joint pain is diagnosed by controlled diagnostic blocks. The accuracy of controlled diagnostic blocks has been demonstrated in multiple studies and cconfirmed in systematic reviews. Controlled diagnostic studies have shown an overall prevalence of lumbar facet joint pain in 31% of the patients with chronic low back pain without disc displacement or radiculitis, with an overall false-positive rate of 30% using a single diagnostic block.

STUDY DESIGN: An observational report of outcomes assessment.

SETTING: An interventional pain management practice setting in the United States.

OBJECTIVE: To determine the accuracy of controlled diagnostic blocks in managing lumbar facet joint pain at the end of 2 years.

METHODS: This study included 152 patients diagnosed with lumbar facet joint pain using controlled diagnostic blocks. The inclusion criteria was based on a positive response to diagnostic controlled comparative local anesthetic lumbar facet joint blocks. The treatment included therapeutic lumbar facet joint nerve blocks.

OUTCOME MEASURES: The sustained diagnosis of lumbar facet joint pain at the end of one year and 2 years based on pain relief and functional status improvement.

RESULTS: At the end of one year 93% of the patients and at the end of 2 years 89.5% of the patients were considered to have lumbar facet joint pain.

LIMITATIONS: The study is limited by its observational nature.

CONCLUSION: Controlled diagnostic lumbar facet joint nerve blocks are valid utilizing the criteria of 80% pain relief and the ability to perform previously painful movements, with sustained diagnosis of lumbar facet joint pain in at least 89.5% of the patients at the end of a 2-year follow-up period.