Abstract No. : ABS2375: Prevalence of facet joint arthropathy in patients with chronic low back pain having prolapsed intervertebral disc- A prospective analytical study

BACKGROUND AND AIMS: Low back pain (LBP) is a major global public health problem with facet joints and intervertebral discs as the common pain generators. This study aimed to determine the prevalence of facet joint arthropathy (FJA) using diagnostic block inpatients with radiologically diagnosed prolapsed intervertebral disc (PIVD). METHODS: This prospective study was conducted from January to July, 2018 on 65 adult patients with chronic LBP (magnetic resonance image(MRI) showing PIVD) . Fifty patients ,who were clinically suspected with FJA ,were given fluoroscopy-guided dual diagnostic median branch block (MBB) with 0.5 ml 2% lignocaine and 0.25% bupivacaine in two different sittings. At least 80% of concordant pain relief (assessed by Visual Analogue Scale(VAS)) was considered as a positive diagnostic block. Patients were divided as group P and group N based on positive and negative diagnostic MBB , respectively. Prevalence of positive block among total study population was calculated. RESULTS: All demographic parameters were comparable between both groups. Number of patients in group P and group N were 36 and 14 respectively. There were significant difference in duration of block, post block pain relief (%) and VAS score after lignocaine and bupivacaine among both the groups(figure 1). No significant complications were seen in any group. Calculated prevalence of positive MBB in the 65 patients was 55.38%. Figure 1 – Comparison of pain relief after medial branch block using lignocaine and bupivacaine CONCLUSION: Symptoms and MRI results fair poorly in diagnosing the exact cause of LBP. Prevalence of FJA was quite high in radiologically diagnosed PIVD which indicates that clinical correlation outweigh spine imaging.