# Intra-articular cervical facet joint corticosteroid injections in patients with increased peri-facet MRI STIR signal. A prospective, multi-center case series

## TL;DR

This study examines the effectiveness of corticosteroid injections in the cervical facet joints for neck pain patients with MRI signs of inflammation.

## Contribution

The study provides new evidence on the short-term efficacy of cervical facet joint corticosteroid injections in patients with MRI-confirmed peri-facet edema.

## Key findings

- 64% of patients reported at least 50% pain improvement within 2-4 weeks post-injection.
- Neck disability scores improved significantly in the short term but showed less improvement at 3 months.
- Global perception of improvement was high in the short term but declined in the intermediate term.

## Abstract

Intra-articular cervical facet joint corticosteroid injections are commonly performed, yet studies demonstrating benefit are limited.

To evaluate success rates of intra-articular cervical facet joint corticosteroid injections in patients with increased peri-facet edema as demonstrated by MRI with STIR sequences.

Preliminary, prospective, multi-center case series.

Thirty-three patients from three independent spine centers.

Consecutive patients were enrolled with axial neck pain and peri-facet joint edema on MRI with STIR sequences when undergoing intra-articular cervical facet joint corticosteroid injections. Outcomes were prospectively collected at 2-4-weeks and at 3-months post-injection. The primary outcome was the proportion of patients with at least 50 % improvement in the numeric rating scale (NRS) pain score. Neck disability index (NDI) and global perception of change (GPC) were evaluated as secondary outcomes.

At 2-4-weeks post-injection, 64 % [95 %CI: 46–79 %] of the 28 patients with follow-up data met criteria for success (≥50 % improvement in NRS). 86 % [95 %CI: 69–94 %] reported that they were better or much better on the GPC, and mean NDI improved from 19.3 to 8.9. At 3-months post-injection, 35 % [95 %CI: 19–54 %] of the 26 patients with follow-up data met criteria for success, and 50 % [95 %CI: 32–68 %] reported that they were better or much better on the GPC. Mean NDI at 3-months was 11.0.

Intra-articular cervical facet joint corticosteroid injections may provide short-term relief of neck pain in patients with peri-facet edema as demonstrated by MRI with STIR sequences. Intermediate-term results are less encouraging.