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Medicine (Baltimore) ; 98(10): e14745, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30855467

RESUMO

Treatment of back pain due to facet joint syndrome has been a challenge for physicians since its recognition ∼80 years ago. Intra-articular injections of steroids, local anesthetics, and phenol have been widely adopted despite their known shortcomings. Recently, intra-articular injection of amniotic membrane-umbilical cord (AMUC) has been utilized in various orthopedic indications, including those involving synovial joints, due to its reported anti-inflammatory properties. Herein, use of AMUC for facet joint syndrome was evaluated.A single-center case series was conducted on patients presenting with pain caused by facet joint syndrome, confirmed by single blocking anesthetic injection and treated using a single intra-articular injection of 50 mg particulate AMUC (CLARIX FLO) suspended in preservative-free saline. Patient reported back pain severity (numerical scale 0-10) and opioid use were compared between baseline and 6 months following treatment.A total of 9 patients (7 males, 2 females), average age 52.1 ±â€Š15.9 years, were included. Five patients with cervical pain had a history of trauma, 1 patient had suffered lumbar facet injury and 3 had degenerative lumbar facet osteoarthritis. All patients had severe pain prior to injection (8.2 ±â€Š0.8) and 4 (44%) were taking opioids (>100 morphine milligram equivalents). Six-month post-treatment, average pain had decreased to 0.4 ±â€Š0.7 (P <.05). All patients had ceased use of prescription pain medications, including opioids. No adverse events, repeat procedures, or complications were reported.Intra-articular injection of AMUC appears to be promising for managing facet pain and mitigating opioid use. Further investigation with larger sample size is warranted.


Assuntos
Âmnio , Produtos Biológicos , Dor Lombar , Manejo da Dor/métodos , Cordão Umbilical , Adulto , Idoso , Produtos Biológicos/administração & dosagem , Produtos Biológicos/efeitos adversos , Doença Crônica , Feminino , Humanos , Injeções Intra-Articulares/métodos , Dor Lombar/etiologia , Dor Lombar/fisiopatologia , Dor Lombar/terapia , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Medição da Dor/métodos , Estudos Retrospectivos , Resultado do Tratamento , Articulação Zigapofisária/patologia , Articulação Zigapofisária/fisiopatologia
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