AB1544 PARAVERTEBRAL MUSCLES TRIGGER POINTS ATTACHED TO FACET JOINTS ARTHROSIS ARE PREFERRED TARGETS FOR ULTRASOUND-GUIDED INTERVENTION TO TREAT LOW BACK PAIN

Background Facet joints (FJ) arthrosis can be a cause of pain and spinal instability considered to potential target for injection treatment. However, FJ arthropathy is difficult diagnosis confirmation associations with syndrome, effectiveness injections debated. Trigger points (TrPs) are major syndromes, dry needling under ultrasound (US) guidance (DN-US) crucial therapeutic treatment myofascial [1], proven effective method various conditions; restore muscle function motion [2], reduce fascia overload [3], improve movement in spine also FJ. Objectives Aim was evaluate the relevance US as efficacy DN-US treat FJ-associated low back facet joints. Methods We included 26 consecutive patients (15 females, 23-57 years old) symptoms LBP, suspected due uni- bilateral assessed at MRI CT three-dimensional reconstructions. Conditions rheumatic, paresis, advanced injury background were excluded. All received protocol by R. Bubnov [1]: MTrP identified according clinical examination, referred pattern, identification; single fine (28G) steel needle DN applied elicit local twitch response (LTR) and/or `needle grasp`. Specific recommendations given preserve effect after DN-US. Results diagnosed bi- unilateral on levels Th11-S1 all patients, fluid joints, deformation, restriction revealed closely localized TrPs paravertebral (multifidus) muscles followed targeted distinguished different patterns (referred - groin pain, pelvic irradiation leg, thigh, etc.) which correlated localizations. Pain decreased VAS from 6-8 baseline 1-4 immediately 3-4 one week procedure. noted decreasing neuropathic detected higher rates lumbar motility, movements particular segments registered functional US; improvement postural balance Additional sessions capsule did not induce significant LTR alleviating compared had imbalance, multiple MTrPs: multifidus thoracic, levels; sacroiliac joint dysfunction, shoulders impingement, other associated abnormalities; MTrPs inactivated, posture imbalance restored. Conclusion helpful detect arthrosis; has good outcome arthrosis. Local interventions targeting most cases relevant approach; less complicated technically, however, more vs Complex assessment correction needed. References [1]Bubnov RV. Evidence-based management: concept integrative medicine applicable? EPMA J 2012, 3(1):13. [2]Bubnov R, Kalika L, Babenko L. Dynamic multilevel evaluation lower extremity spine. Annals Rheumatic Diseases 2018;77:1699. http://dx.doi.org/10.1136/annrheumdis-2018-eular.3949 [3]Bubnov THE ROLE OF THORACOLUMBAR FASCIA ULTRASOUND IN LOW BACK PAIN IMPLICATION FOR GUIDED DRY NEEDLING. 2022;81:1714. http://dx.doi.org/10.1136/annrheumdis-2022-eular.1936 Acknowledgements: NIL. Disclosure Interests None Declared.