Facet pain in thoracic compression fractures.

OBJECTIVE

To determine if thoracic facet joints may be a significant secondary pain generator in patients with compression fractures. Traditionally, pain from vertebral compression fractures has been attributed to vertebral body itself. Compression fractures have been shown to increase thoracic kyphosis and thereby increase the thoracic flexion moment; these changes eventually increase the shear stress on the posterior elements.

DESIGN

We present a small case series of patients with thoracic compression fractures managed with intra-articular facet injections.

SETTING

Tertiary care academic medical center.

PARTICIPANTS

Two patients with thoracic compression fractures.

INTERVENTIONS: The subjects received fluoroscopically guided thoracic facet steroid injections for pain management.

MAIN OUTCOME: Change in verbal analog pain score.

RESULTS

Patients with thoracic compression fractures received significant long-lasting relief after receiving fluoroscopically guided intra-articular injections.

CONCLUSION

Facet joints may be abnormally stressed due to the increasing thoracic flexion moment in anterior compression fractures, which may serve as a secondary pain generator; intra-articular facet blocks may be an alternative to vertebroplasty.