Endoscopic Facet Debridement for the treatment of facet arthritic pain - a novel new technique

Haufe, Scott M.W.; Mork, Anthony R.

doi:10.7150/ijms.7.120

Cited by 24 publications

(23 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, an endoscopically controlled puncture can be performed in cases of severe joint effusion. Haufe and Mork 10 described such an endoscopically controlled technique that regularly dissected the FJ capsule and denuded the joint's surface by use of a holmium laser. They argued that their technique would result in longer-lasting pain reduction compared with other techniques because the nerve's capability of regenerating is counteracted by removing the nerve's endplate.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Sacrolumbar Facet Joint Denervation in Osteoarthritic and Degenerated Zygapophyseal Joints

Walter

Schildberg

Rommelspacher

2018

Arthroscopy Techniques

View full text Add to dashboard Cite

Chronic low-back pain (CLBP) has an increasing incidence and yields a tremendous health economic burden. There are different anatomic structures that may be responsible for CLBP, such as lumbar intervertebral discs, sacroiliac joints, nerve root dura, fascia, ligaments, and muscles. However, to a large extent, CLBP is associated with structural changes in and around the facet (zygapophyseal) joint. If conservative treatment strategies fail, symptoms and pain can effectively be reduced by denervation or rhizotomy of the medial branch of the dorsal ramus of the spinal nerve through radiofrequency ablation. In this technical description with video, we present an endoscopic technique for radiofrequency rhizotomy. This technique has the advantage of directly visualizing the facet joint as well as its surrounding structures including the medial branches.

show abstract

Section: Discussionmentioning

confidence: 99%

Endoscopic Sacrolumbar Facet Joint Denervation in Osteoarthritic and Degenerated Zygapophyseal Joints

Walter

Schildberg

Rommelspacher

2018

Arthroscopy Techniques

View full text Add to dashboard Cite

show abstract

“…Different reports demonstrated that endoscopic facet joint denervation may be more effective than percutaneous. [12][13][14][15] In the recent study of Walter et al, 41 to 71% of patients reported sustained pain relief for up to 22 months. 14 Li et al showed good to excellent outcomes in 97.8% of their patients after 1 year.…”

Section: Discussionmentioning

confidence: 97%

“…Additionally, it is also possible to extract capsular tissue with the end-plate receptors to make nerve regeneration more difficult. 12 Small extraspinal synovial cysts can be removed, and surrounding tissue can be rinsed and shrunken (►Fig. 3).…”

Section: Discussionmentioning

confidence: 99%

“…15 Exceptional results after endoscopic facet procedures were also demonstrated by others. 12,13 Furthermore, authors described more intense endoscopic procedures compared with pure denervation with debridement and removal of end-plate receptors that may adhere to the bone and capsular tissue. 12 Our population showed a clear improvement on the NAS after the procedure.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic 4-MHz Radiofrequency Treatment of Facet Joint Syndrome Is More Than Just Denervation: One Incision for Three Facets

Woiciechowsky

Richter

2020

J Neurol Surg A Cent Eur Neurosurg

View full text Add to dashboard Cite

Background and Study Aims Low back pain is well documented as an extremely common health problem. The most frequently used treatment is radiofrequency denervation for chronic low back pain. However, different clinical studies could only show a limited to no improvement regarding the decrease of pain intensity and duration of the effect. The main reasons for these limited effects seem to be due to the size of the lesion and difficulties in locating the exact placement of the cannula near the medial branch as well as or additional pathologies. Using an endoscope, it is possible to coagulate the facet joints and the medial branch under visual control and consider other pathologies such as extraspinal synovial cysts. Patients In this retrospective study, we included 28 patients with low back pain, with a duration > 6 months and a 50% pain reduction on the numeric analog scale (NAS) after a diagnostic block. All patients received endoscopic facet joint denervation of three facets on the left and right side using only one incision on each side with an exploration of the surrounding tissue. Telephone interviews were conducted with all patients. The outcome was determined with Odom's criteria, percentage reduction NAS, subjective assessment of the patient, and duration of the effect. Results According to Odom's criteria, 68% of the patients showed “acceptable” to “excellent” results and confirmed that denervation helped them manage their daily lives better. The average pain reduction in the responder group was 47% with an average duration of 7.8 months. Conclusion In this retrospective study, we demonstrated the practicability and effectiveness of the endoscopic facet joint denervation procedure in the treatment of chronic low back pain using only one incision for three facets. Further studies should investigate if this procedure is more effective than percutaneous radiofrequency denervation.

show abstract

“…A visualized endoscopic rhizhotomy to target the variable dorsal ramus anatomy can provide a more consistent and long lasting benefit than the "gold standard" traditional X-ray guided technique [49]. There is comparable efficiency of endoscopic facet debridement to radiofrequency ablation of the dorsal nerve [50]. Laser denervation of the dorsal capsule of the facet joint appears to be a more preferable target for facet joint denervation [51].…”

Section: Alternate Techniquesmentioning

confidence: 99%

Untitled

2019

J Musculoskelet Disord Treat

View full text Add to dashboard Cite

persists for ≥ 3 months. These acute episodes develop into chronic low back pain (persists more than 3 months) in 8-12% of patients [3]. 85% are non-specific low back pain not attributable to a specific pathology (fracture, infection, osteoporosis, tumour) [4]. Goldthwait, in 1911, was the first to suggest that facet joint could be a source of low back pain. The potential of the zygapophyseal joint as a unique source of lumbar pain has been demonstrated in several histological studies [5]. But interestingly, it was not until 1933, the term "facet syndrome" was used by Ghormley to describe the condition. Pathophysiology This condition is associated with osteoarthritis with the pain originating from the synovium, cartilage and capsule of the facet joint [6]. Two medial branches of the primary dorsal rami (nerve of Luschka) of each spinal nerve innervate a facet joint [7]. The joints are covered by nociceptors with free and encapsulated nerve terminations that contain substance P [8]. It is this facet joint capsule degeneration that is described as "facet syndrome" or "zygapophysial joint pain". Cadaveric studies show that facet arthrosis is present in 100% of the specimens older than 60 years [9]. Eubanks, et al. argue that 57% of patient above the age of 30 years have facet arthrosis [10]. Clinical Tests There are different clinical tests for facet joint pain described in the literature but none of these can reliably distinguish it from other sources of pain. Imaging

show abstract

Endoscopic Facet Debridement for the treatment of facet arthritic pain - a novel new technique

Cited by 24 publications

References 17 publications

Endoscopic Sacrolumbar Facet Joint Denervation in Osteoarthritic and Degenerated Zygapophyseal Joints

Endoscopic Sacrolumbar Facet Joint Denervation in Osteoarthritic and Degenerated Zygapophyseal Joints

Endoscopic 4-MHz Radiofrequency Treatment of Facet Joint Syndrome Is More Than Just Denervation: One Incision for Three Facets

Untitled

Contact Info

Product

Resources

About