PMID- 23159978
OWN - NLM
STAT- MEDLINE
DCOM- 20130627
LR  - 20220408
IS  - 2150-1149 (Electronic)
IS  - 1533-3159 (Linking)
VI  - 15
IP  - 6
DP  - 2012 Nov-Dec
TI  - Systematic review of the therapeutic effectiveness of cervical facet joint 
      interventions: an update.
PG  - E839-68
AB  - BACKGROUND: The prevalence of chronic, recurrent neck pain is approximately 15% 
      of the adult general population. Controlled studies have supported the existence 
      of cervical facet or zygapophysial joint pain in 36% to 67% of these patients, 
      when disc herniation, radiculitis, and discogenic are not pathognomic. However, 
      these studies also have shown false-positive results in 27% to 63% of the 
      patients with a single diagnostic block. There is also a paucity of literature 
      investigating therapeutic interventions of cervical facet joint pain. STUDY 
      DESIGN: Systematic review of therapeutic cervical facet joint interventions. 
      OBJECTIVE: To determine and update the clinical utility of therapeutic cervical 
      facet joint interventions in the management of chronic neck pain. METHODS: The 
      available literature for utility of facet joint interventions in therapeutic 
      management of cervical facet joint pain was reviewed. The quality assessment and 
      clinical relevance criteria utilized were the Cochrane Musculoskeletal Review 
      Group criteria as utilized for interventional techniques for randomized trials 
      and the criteria developed by the Newcastle-Ottawa Scale criteria for 
      observational studies. The level of evidence was classified as good, fair, and 
      limited or poor based on the quality of evidence developed by the U.S. Preventive 
      Services Task Force (USPSTF). Data sources included relevant literature 
      identified through searches of PubMed and EMBASE from 1966 to June 2012, and 
      manual searches of the bibliographies of known primary and review articles. 
      OUTCOME MEASURES: The primary outcome measure was pain relief (short-term relief 
      = up to 6 months and long-term > 6 months). Secondary outcome measures were 
      improvement in functional status, psychological status, return to work, and 
      reduction in opioid intake. RESULTS: In this systematic review, 32 manuscripts 
      were considered for inclusion. For final analysis, 4 randomized trials and 6 
      observational studies met the inclusion criteria and were included in the 
      evidence synthesis. Based on one randomized, sham-controlled, double-blind trial 
      and 5 observational studies, the indicated evidence for cervical radiofrequency 
      neurotomy is fair. Based on one randomized, double-blind, active-controlled trial 
      and one prospective evaluation, the indicated evidence for cervical medial branch 
      blocks is fair. Based on 2 randomized controlled trials, the evidence for 
      cervical intraarticular injections is limited. LIMITATIONS: Paucity of the 
      overall published literature and specifically lack of literature for 
      intraarticular cervical facet joint injections. CONCLUSIONS: The indicated 
      evidence for cervical radiofrequency neurotomy is fair. The indicated evidence 
      for cervical medial branch blocks is fair. The indicated evidence for cervical 
      intraarticular injections with local anesthetic and steroids is limited.
FAU - Falco, Frank J E
AU  - Falco FJ
AD  - Mid Atlantic Spine & Pain Physicians of Newark, Newark, DE, USA. cssm01@aol.com
FAU - Manchikanti, Laxmaiah
AU  - Manchikanti L
FAU - Datta, Sukdeb
AU  - Datta S
FAU - Wargo, Bradley W
AU  - Wargo BW
FAU - Geffert, Stephanie
AU  - Geffert S
FAU - Bryce, David A
AU  - Bryce DA
FAU - Atluri, Sairam
AU  - Atluri S
FAU - Singh, Vijay
AU  - Singh V
FAU - Benyamin, Ramsin M
AU  - Benyamin RM
FAU - Sehgal, Nalini
AU  - Sehgal N
FAU - Ward, Stephen P
AU  - Ward SP
FAU - Helm, Standiford 2nd
AU  - Helm S 2nd
FAU - Gupta, Sanjeeva
AU  - Gupta S
FAU - Boswell, Mark V
AU  - Boswell MV
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - Pain Physician
JT  - Pain physician
JID - 100954394
RN  - 0 (Analgesics)
SB  - IM
MH  - Analgesics/administration & dosage
MH  - Catheter Ablation
MH  - Cervical Vertebrae
MH  - Chronic Pain/*therapy
MH  - Clinical Trials as Topic
MH  - Humans
MH  - Injections, Intra-Articular
MH  - Neck Pain/*therapy
MH  - Nerve Block
MH  - Pain Management/*methods
MH  - *Zygapophyseal Joint
EDAT- 2012/11/20 06:00
MHDA- 2013/06/29 06:00
CRDT- 2012/11/20 06:00
PHST- 2012/11/20 06:00 [entrez]
PHST- 2012/11/20 06:00 [pubmed]
PHST- 2013/06/29 06:00 [medline]
PST - ppublish
SO  - Pain Physician. 2012 Nov-Dec;15(6):E839-68.