A case of facet joint pain with morphological abnormalities treated with interventional therapy under the aid of 3D-CT

Abstract

Lumbar facet joint hypoplasia is a very rare congenital disease that can cause low back pain. We report a case of lumbar facet joint pain (LFJP) with hypoplasia of the lumbar facet joint, in which interventional treatment was performed using 3D-CT images. The patient was a male in his twenties. CT showed hypoplasia of the right L5/S1 facet joint and there were spontaneous pain and tenderness in the same area, These findings led us to suspect LFJP. Facet block (FB) under fluoroscopic guidance was attempted, but it was difficult to identify the facet joint due to its morphological abnormality, so it was carried out by comparing 3DCT images together. Since FB was effective, we diagnosed his pain as LFJP. Because the effect of FB was short-term, facet rhizotomy was also performed using 3D-CT images, and long-term pain relief was obtained. In the case of nerve block with morphological abnormalities as in the present case, 3DCT images were very useful.