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Percutaneous spinal procedures

Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK

• Percutaneous spinal procedures have diagnostic and/or therapeutic roles in the management of back pain.
  
• Discography remains the only test that can confirm if a component of the patients' pain arises from a particular disc.
  
• The value of therapeutic disc procedures remains controversial, as there are very few randomized controlled studies.
  
• Although lumbar facet joint injections for facet syndrome are an established procedure, the evidence for their efficacy is limited.
  
• Lumbar facet joint injections may be used to treat sciatic pain arising from synovial cysts arising from facet joints.