| Abstrakt: |
Background: Low back pain (LBP) is a prevalent musculoskeletal issue contributing significantly to disability and economic costs. The lumbar facet joints, which stabilize spinal segments during movement, can degenerate with age, causing lumbar osteoarthritis (OA). This degeneration, particularly at the L4-L5 and L5-S1 levels, often triggers pain. Facet joint injections (FJI) are a common intervention, yet their effects on spinopelvic alignment and functional outcomes in lumbar OA remain underexplored. Objective: To evaluate the effects of FJI at different lumbar levels on spinopelvic parameters and functional outcomes in patients with lumbar OA, and to analyze the relationship between changes in these parameters and functional outcomes. Materials and Methods: A prospective study was conducted at MKCG Medical College, Berhampur, including 144 patients with lumbar OA unresponsive to conservative treatment. Patients were divided into Group 1 (two-level FJI at L4-L5 and L5-S1) and Group 2 (five-level FJI from L1 to S1). Injections were administered with fluoroscopic guidance using a mixture of lidocaine and triamcinolone acetonide. Functional outcomes were assessed using the Oswestry Disability Index (ODI) before and three months postinjection, alongside radiographic measurements of spinopelvic parameters (pelvic incidence, sacral slope, and pelvic tilt). Statistical analyses included paired and independent t-tests, with correlations assessed via Pearson's coefficient. Results: Of the 164 patients, 97 were female, with a mean age of 60.6 ± 6.4 years. Group 2 showed a significant reduction in ODI scores post-injection (p = 0.009) and in pelvic tilt (p = 0.021), while Group 1 demonstrated no significant changes. Correlation analysis revealed a moderate positive association between ODI changes and pelvic tilt (r = 0.576, p = 0.013), indicating that greater improvements in functional outcomes were associated with pelvic tilt adjustments. Discussion: The findings suggest that multilevel FJI offers enhanced functional outcomes and adjustments in spinopelvic alignment, particularly pelvic tilt, compared to two-level FJI. These results align with previous studies showing that FJI can impact lumbar alignment, with implications for functional improvement in lumbar OA. Limitations include a short follow-up duration and lack of direct pain intensity assessment beyond ODI. Conclusion: Multilevel FJI in lumbar OA patients significantly improves functional outcomes and reduces pelvic tilt, potentially influencing lumbar alignment and facet joint orientation. These insights suggest that broader lumbar levels should be targeted in FJI for meaningful clinical improvements, with future research needed to refine patient-specific FJI approaches. [ABSTRACT FROM AUTHOR] |
