Intra-articular cervical facet joint corticosteroid injections in patients with increased peri-facet MRI STIR signal. A prospective, multi-center case series

Abstract

Background

Intra-articular cervical facet joint corticosteroid injections are commonly performed, yet studies demonstrating benefit are limited.

Purpose

To evaluate success rates of intra-articular cervical facet joint corticosteroid injections in patients with increased peri-facet edema as demonstrated by MRI with STIR sequences.

Study design

Preliminary, prospective, multi-center case series.

Patient sample

Thirty-three patients from three independent spine centers.

Methods

Consecutive patients were enrolled with axial neck pain and peri-facet joint edema on MRI with STIR sequences when undergoing intra-articular cervical facet joint corticosteroid injections. Outcomes were prospectively collected at 2-4-weeks and at 3-months post-injection. The primary outcome was the proportion of patients with at least 50 % improvement in the numeric rating scale (NRS) pain score. Neck disability index (NDI) and global perception of change (GPC) were evaluated as secondary outcomes.

Results

At 2-4-weeks post-injection, 64 % [95 %CI: 46–79 %] of the 28 patients with follow-up data met criteria for success (≥50 % improvement in NRS). 86 % [95 %CI: 69–94 %] reported that they were better or much better on the GPC, and mean NDI improved from 19.3 to 8.9. At 3-months post-injection, 35 % [95 %CI: 19–54 %] of the 26 patients with follow-up data met criteria for success, and 50 % [95 %CI: 32–68 %] reported that they were better or much better on the GPC. Mean NDI at 3-months was 11.0.

Conclusions

Intra-articular cervical facet joint corticosteroid injections may provide short-term relief of neck pain in patients with peri-facet edema as demonstrated by MRI with STIR sequences. Intermediate-term results are less encouraging.