CLINICAL-FEATURES OF PATIENTS WITH PAIN STEMMING FROM THE LUMBAR ZYGAPOPHYSIAL JOINTS - IS THE LUMBAR FACET SYNDROME A CLINICAL ENTITY

Study Design. This study is a prospective cross-sectional analytic stu dy. Objectives. The authors determined the prevalence and clinical fea tures of patients with pain stemming from the lumbar zygapophysial joi nts. Summary of Background Data. Previous studies have demonstrated a wide range of prevalence for zygapophysial joint pain and conflicting results with regard to clinical signs. Methods. One hundred and sevent y-six consecutive patients with chronic low back pain were investigate d with a series of screening zygapophysial joint blocks using lignocai ne and confirmatory blocks using bupivacaine. Results. Forty-seven per cent of patients had a definite or greater response to the screening i njection at one or more levels but only 15% had a 50% or greater respo nse to a confirmatory block. Response to zygapophysial joint injection was not associated with any single clinical feature or set of clinica l features. Conclusions. The zygapophysial joint is an important sourc e of pain but the existence of a ''facet syndrome'' must be questioned .