CO-RELATION BETWEEN MODIC CHANGES IN LUMBAR SPINE WITH DIAGNOSTIC LUMBAR FACET MEDIAL BRANCH BLOCKS FOR RELIEF OF CHRONIC NON SPECIFIC LOW BACK PAIN

Introduction: Back pain potentially associated with modic changes in lumbar spine, radiculopathy or spinal stenosis, specic spinal cause or nonspecic low back pain. Patients with non-specic low back pain comprised of 85% of all patients of chronic low back pain. Lumbar facet medial branch block can be used as one of the modality for relief of chronic non-specic low back pain as well as for the diagnosis of pain due to medic changes in lumbar spine. To co-relate duration and degree of pain relief after control Objectives: led medial branch blocks with different grades of modic changes in lumbar spine in patients of chronic non- specic low back pain. Methods: The present study was prospective study. A total of 75 patients were enrolled and divided into 3 groups of 25 each on the basis of modic changes. Patients of all the three groups received diagnostic medial branch blocks at three different levels i.e. L2-L4, using a 22 gauge spinal needle with 0.5 ml, 0.25% levo-bupivacaine (isobaric) underuoroscopic guidance and co-relate duration and degree of pain relief using Numeric Rating Scale (NRS) score as well as overall improvement in the quality of life of patient through SF-12 Health Survey. We found signicant variat Results: ion in the age distribution of the patients in our study. The patients with modic changes (type I and type II) in the lumbar spine were more in the elderly age group. On intergroup comparison -Numeric Rating Scale (NRS) showed signicant reduction in pain scores between group 0 and group I, group 0 and group II and group I and group II (p<0.001) at 1st and 3rd week .Both PCS-SF12 and MCS-12 Health Survey at 3rd week after treatment showed signicant improvement in overall quality of life of patients from baseline in all the study groups (p<0.0001) In our study resul Conclusions: ts showed that improvement of pain relief was signicantly better in the patients of group 0 (patients with no modic changes) as compared to the patients of group I ((patients with type 1 modic changes) and patients of group II (patients with type 2 modic changes) at 3 weeks of lumbar medial branch blocked.