Paravertebral spinal injection for the treatment of patients with degenerative facet osteoarthropathy: Evidence of motor performance improvements based on objective assessments

Nima Toosizadeh, Homayoon Harati, Tzu Chuan Yen, Cindy Fastje, Jane Mohler, Bijan Najafi, Michael Dohm

Research output: Contribution to journalArticlepeer-review

Abstract

Background This study examined short- and long-term improvements in motor performance, quantified using wearable sensors, in response to facet spine injection in degenerative facet osteoarthropathy patients. Methods Adults with confirmed degenerative facet osteoarthropathy were recruited and were treated with medial or intermediate branch block injection. Self-report pain, health condition, and disability (Oswestry), as well as objective motor performance measures (gait, balance, and timed-up-and-go) were obtained in five sessions: pre-surgery (baseline), immediately after the injection, one-month, three-month, and 12-month follow-ups. Baseline motor performance parameters were compared with 10 healthy controls. Findings Thirty patients (age = 50 (14) years) and 10 controls (age = 46 (15) years) were recruited. All motor performance parameters were significantly different between groups. Results showed that average pain and Oswestry scores improved by 51% and 24%, respectively among patients, only one month after injection. Similarly, improvement in motor performance was most noticeable in one-month post-injection measurements; most improvements were observed in gait speed (14% normal walking, P < 0.02), hip sway within balance tests (63% eyes-open P < 0.01), and turning velocity within the timed-up-and-go test (28%, P < 0.02). Better baseline motor performance led to better outcomes in terms of pain relief; baseline turning velocity was 18% faster among the responsive compared to the non-responsive patients. Interpretations Spinal injection can temporarily (one to three months) improve motor performance in degenerative facet osteoarthropathy patients. Successful pain relief in response to treatment is independent of demographic characteristics and initial pain but dependent on baseline motor performance. Immediate self-reported pain relief is unrelated to magnitude of gradual improvement in motor performance.

Original languageEnglish (US)
Pages (from-to)100-108
Number of pages9
JournalClinical Biomechanics
Volume39
DOIs
StatePublished - Nov 1 2016
Externally publishedYes

Bibliographical note

Funding Information:
The project was supported in part by awards from the Flinn Foundation (award number 1907 ) and the National Institute on Aging (NIH-Phase II STTR award number 2R42AG032748 ). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Flinn Foundation or the National Institute on Aging. The study was approved by the University of Arizona Institutional Review Board Committee (Protocol Number 1200000616A029). The authors declare that they have no competing interests.

Publisher Copyright:
© 2016

Keywords

  • Balance
  • Low back pain
  • Motor performance
  • Osteoarthropathy
  • Spine injection
  • Wearable technology

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