PAIN FROM THE LUMBAR ZYGAPOPHYSIAL JOINTS - A TEST OF 2 MODELS

One hundred seventy-six consecutive patients with chronic low-back pai n and no history of previous lumbar surgery were studied to test the c linical criteria of Fairbank et al. and Helbig and Lee for zygapophysi al joint pain. All patients underwent a history, examination, and a se ries of zygapophysial joint injections or blocks of the medial branche s of the dorsal ramus with lignocaine. Those patients responding to th e first series of blocks were given confirmatory blocks using bupivaca ine. None of the clinical features tested was found to be associated w ith response to the confirmatory block. The Fairbank et al. and Helbig and Lee criteria were shown to be unreliable in distinguishing pain o f zygapophysial joint origin from pain of other origins.