Table 3.

Clinical Trials Evaluating Intra-Articular Steroid Injections for Lumbar Facetogenic LBP

Author, Year	Number and Type of Patients	Follow-Up Period	Results
Kennedy et al,103 2019	56 consecutive pts who had ≥80% pain relief during an initial screening MBB were randomly divided into two groups. After second MBB, 29 of 56 received intra-articular corticosteroid, of whom 24 also had a positive MBB. 27 of 56 received intra-articular injection of saline into the LFJ during the confirmatory MBB, of whom 22 also had a positive MBB.	1 year.	There was no statistically significant difference in the need for a radiofrequency ablation between the groups (16/24 steroid, 67%) vs (15/22 saline, 68%).
Kennedy et al,102 2018	28 pts with facetogenic chronic LBP confirmed by MBB were randomly divided into two groups. Two groups received either intra-articular corticosteroid or saline.	1 year.	No statistically significant difference in the need for radiofrequency neurotomy between the groups.
Lakemeier et al,105 2016	56 pts with LBP were randomly assigned to 29 pts who received intra-articular steroid infiltrations, and 27 pts who underwent radiofrequency denervation.	6 months.	24 of 29 pts in the steroid injection group and 26 of 27 pts in the denervation group completed the 6-month follow-up. There were no significant differences between the 2 groups for pain relief and functional improvement.
Ribeiro et al,101 2013	60 pts with LFJ syndrome randomly received triamcinolone hex acetonide intra-articular injection, or triamcinolone acetonide intramuscular injection.	24 weeks.	Both treatments were effective, with a slight superiority of the intra-articular injection of steroids over intramuscular injection.
Pneumaticos et al,106 2006	47 pts with LBP were scheduled and randomized in a 2:1 ratio to undergo intra-articular local anesthetic and steroid injections.	6 months.	At 1 month, 13 of 15 pts had improvement in pain score of greater than 1 standard deviation whereas improvement occurred in only two of 16 pts in group A2 and five of 16 pts in group B.
Fuchs et al,107 2005	60 pts were included in this randomized, controlled, blind-observer clinical study and randomly assigned to two groups to receive 10 mg sodium hyaluronate or 10 mg glucocorticoids per facet joint.	6 months.	Pts who received sodium hyaluronate injections experienced a 40% decrease in pain scores vs a 56% reduction in those pts who received steroid.
Carette et al,108 1991	95 pts with LBP who reported immediate relief of their pain after injections of local anesthetic into the LFJ. They were randomly assigned to receive, under fluoroscopic guidance, injections of either methylprednisolone acetate (20 mg; n = 49) or isotonic saline (n = 48) in the same LFJ.	6 months.	After one month, 42% of the pts who received methylprednisolone and 33% of those who received placebo reported marked or very marked improvement. At the six-month evaluation, the pts treated with methylprednisolone reported more improvement, less pain and less physical disability.

Abbreviations: MBB, medial branch block; pts, patients; LFJ, lumbar facet joint; LBP, low back pain.