Radiofrequency facet joint neurotomy in treatment of facet syndrome.

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Radiofrequency facet joint neurotomy in treatment of facet syndrome.

J Spinal Disord Tech. 2010 Oct;23(7):480-5

Authors: Yilmaz C, Kabatas S, Cansever T, Gulsen S, Coven I, Caner H, Altinors N

Abstract
STUDY DESIGN: Retrospective analyses of 50 patients with lumbar facet syndrome treated with lumbar facet joint neurotomy.
OBJECTIVE: To establish the efficacy of lumbar facet joint neurotomy under optimum conditions in selected patients.
SUMMARY OF BACKGROUND DATA: With the realization of the significance of facet joints in the etiology of chronic low back pain over the last decade, many studies were conducted about various methods of treating the facet joint syndrome.
METHODS: Fifty patients with lumbar facet syndrome with at least 80% pain relief by controlled, diagnostic medial branch blocks underwent lumbar facet joint neurotomy. Before surgery, all were examined carefully both clinically and radiologically and evaluated by visual analog scale (VAS) and descriptive system of health-related quality of life state (EQ5D) measures of pain, disability, and treatment satisfaction. All outcome measures were repeated postoperatively and at 12 months after surgery.
RESULTS: Of the 50 patients 35 were females and 15 were males with a mean age of 51.82±16.99 years. One level was treated in 26 patients, 2 levels in 14, 3 levels in 8, and 4 levels were treated in 2 patients. Symptom duration was ranging between 2 and 24 months with a mean of 7.64±5.98 months. Mean preoperative, postoperative, and at the 12th month VAS were 75.2±11.29, 23.8±10.28, and 24.6±11.817, respectively.Forty-eight percent of patients obtained a relative reduction of at least 70% in VAS, and 86% obtained a reduction of at least 60% at the 12th month. Health-related quality of life state was improved in all patients. When the VAS scores were evaluated with respect to the ages of patients, level numbers, and preoperative symptom duration, no significant differences were found, [0.106, 0.635 and 0.526 (preoperative VAS); 0.033, 0.555, and 0.235 (postoperative VAS); 0.701, 0.978, and 0.155 (follow-up VAS), respectively].
CONCLUSIONS: The most important factors determining success of this procedure is strict patient selection criteria and technique of the procedure.

PMID: 20124916 [PubMed – indexed for MEDLINE]