Evaluation of Pain Level Reduction After Low-dose Radiation in Symptomatic Facet Joint Arthritis

Inclusion Criteria: * Patients with degenerative symptomatic facet joint osteoarthritis confirmed by MRI (lumbar spine) and standing X-ray * Patients who underwent treatment for facet joint syndrome at the Dept. of Orthopaedic Surgery and Traumatology of KSA (Kantonsspital Aarau) or Dept. of Rheumatology of KSA or Dept. of Neurosurgery of KSA, onset of symptoms and treatment with pain medication and physiotherapy * The informed consent form for participation in the study was signed * Stated willingness to comply with all study procedures and availability for the duration of the study * Age ≥ 45 years * Karnofsky Performance Status (KPS) ≥ 80 % * Ability to take steroids and bridge or pause NOAC (New oral anticoagulants) / Marcoumar * Show a positive Tracer-Uptake in the SPECT-CT in max. 4 facet joints of the lumbar spine (regardless of radiologic changes in MRI or CT) * Immediate ≥ 70% pain reduction after 1 positive diagnostic infiltration of the suspected facet joint(s) * Negative middle-/long-term effect (4-12 weeks after first steroid injection, defined as "NRS 5-10 at 4-12 weeks") Exclusion Criteria: * Any previous infiltration therapy in the suspected spine region (+/- 3 segments) within the last 3 years * Any previous radiotherapy, radiofrequency ablation, other pain modulating interventions (e.g. thermos/-cryoablation or spinal cord stimulators) or surgery in the suspected spine region (+/- 3 segments) * Prior or concurrent malignancy (≤ 5 years prior to enrolment …