Lumbar Zygapophysial Joint Radiofrequency Denervation: A Long-Term Clinical Outcome Study

Manejias, Elizabeth M.; Hu, Jason; Tatli, Yusuf; Lutz, Gregory E.

doi:10.1007/s11420-008-9082-7

Cited by 10 publications

(7 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The current study also shows that repeated RF medial branch neurotomy from recurrent pain after successful pain relief is also effective in about 85% of patients that were also similar to previous reports 6,10,15,17) . There were no neurological complications from repeated procedures as in first cases.…”

Section: Discussionsupporting

confidence: 90%

The Efficacy of Repeated Radiofrequency Medial Branch Neurotomy for Lumbar Facet Syndrome

Son

Kim

et al. 2010

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Objective : Radiofrequency (RF) medial branch neurotomy is an effective management of lumbar facet syndrome. However, pain may recur after period of time. When pain recurs, it can be repeated, but the successful outcome and duration of relief from repeated procedures are not clearly known. The objective of this study was to determine the success rate and duration of pain relief from repeated radiofrequency medial branch neurotomy for lumbar facet syndrome. Methods : A retrospective review of medical records was done on 60 consecutive patients, from March of 2006 to February of 2009, who had an initial successful RF neurotomy but subsequently underwent repeated procedures due to recurrence of pain. All procedures were done in carefully selected patients after at least two responsive medial branch nerve blocks. C-arm fluoroscopic guide, impedance, sensory and motor threshold monitoring tools were used for the precise placement of electrodes. Responses of repeated procedures were compared with initial radiofrequency neurotomy for success rates and duration of pain relief. Results : There were 48 females and 12 males. Mean age was 52.4 years (range, 26-83). RF medial branch neurotomy was done on one side in 38 and both sides in 22 patients, each covering at least three segments. Average visual analog scale at last procedure was 6.8. Twelve patients had previous lumbar operations, including 4 patients with instrumentations. Fifty-five patients had two procedures and five patients had three procedures. Mean duration of successful pain relief (> 50% of previous pain for at least 3 months period) after initial radiofrequency neurotomy was 10.9 months (range, 3-28) in 51 (85%) patients. From repeated procedures, successful pain relief was seen in 50 (91%) patients with average duration of 10.2 months (range, 3-24). Five patients had third procedure, which was successful in 4 (80%) patients with mean duration of 9.8 months (range, 5-16). This was not statistically different from initial results. There were no permanent neurological complications from the procedures. Conclusion : Results of this study indicate that the frequency of success and durations of relief from repeated RF medial branch neurotomy for lumbar facet syndrome are similar to initial results that provided relatively prolonged period of pain relief without major side effects. Each procedure seems to provide successful pain relief for about 10 months in more than 85% of carefully selected patients when properly done. KEY WORDS :Facet syndrome˙ Zygapophyseal joint denervation˙ Radiofrequency neurotomy˙ Repeat operation˙ Outcome.

show abstract

Section: Discussionsupporting

confidence: 90%

The Efficacy of Repeated Radiofrequency Medial Branch Neurotomy for Lumbar Facet Syndrome

Son

Kim

et al. 2010

J Korean Neurosurg Soc

View full text Add to dashboard Cite

show abstract

“…Compared with operative options, it is considered a relatively safe and less complicated technique; its recognized adverse effects only being transient radiculopathy and a case report of skin burn due to poor earthing (7,(9)(10)(11). Extensive literature exists on this technique with a number of randomized controlled studies suggesting its efficacy against placebo (10,(12)(13)(14)(15)(16), while other studies have questioned its efficacy (8,9,11,17,18). Evaluation of evidence regarding this technique has often drawn criticism for the lack of volume of high-quality studies for comparison because existing randomized controlled trials on this procedure have different diagnostic criteria and surgical techniques between them (17).…”

Section: Introductionmentioning

confidence: 99%

Repeat Percutaneous Radiofrequency Facet Joint Denervation for Chronic Back Pain: A Prospective Study

Zotti

Osti

2010

Journal of Musculoskeletal Pain

View full text Add to dashboard Cite

Objective: To investigate whether repeat lumbar percutaneous radiofrequency facet joint denervation [RFJD] is an efficacious ongoing treatment for chronic low back pain [LBP] using the Low Back Outcome Score [LBOS] and subjective measures of patient satisfaction. Methods:A prospective open-label, single intervention study was carried out on a consecutive series of patients undergoing repeat lumbar RFJD performed by a single operator in 2007. Patients with an initially successful RFJD procedure were selected for the study excluding patients with greater than four procedures in total. Lumbar medial branch neurotomy was conducted using a 20-gauge silicone-coated probe inserted under fluoroscopic control and neuroleptic intravenous sedation with radiofrequency thermal energy applied for 90 seconds per joint at a maximum probe tip temperature of 90 • C. The patients completed a LBOS questionnaire before and 12 months following the repeat RFJD procedure. They were also asked about their satisfaction with and the duration of pain relief related to their repeat procedure.Results: Sixty-two patients completed the study. At 12-month follow-up, clinical outcomes were improved with the proportion of patients with poor rating according to LBOS decreasing from 69.4 percent pre-procedure to 41.9 percent after repeat RFJD [P < 0.01]. Overall, 69.3 percent of patients were satisfied with the procedure with a median average duration of eight to nine months for pain relief . There were no complications in this series.Conclusion: Repeat lumbar RFJD, in this cohort of appropriately selected patients, achieved a high level of satisfaction and improved LBOS score, and may be a valid option for ongoing treatment for patients with chronic LBP. It would appear that a blinded, randomized, sham treatment-controlled clinical trial would be warranted. J Muscoskeletal Pain Downloaded from informahealthcare.com by The University of Manchester on 11/02/14 For personal use only.

show abstract

“…Gulati and Weinstein [12] postulated that intraspinal gas probably comes from tears in the annulus fibrosis in disc with VP. The gas can be associated with a herniation and can be found within the herniation itself [15,18], or it can also be found free within the spinal canal, with or without herniation [12].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Intradiscal Aspiration of a Lumbar Vacuum Disc Herniation: A Case Report

Pak

Hoffman

Herzog

et al. 2011

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

Self Cite

View full text Add to dashboard Cite

We report a case of an 83-year-old gentleman presenting with acute low back pain and radicular left lower extremity pain after golfing. A magnetic resonance imaging (MRI) of the lumbar spine revealed a low-signal-density lesion compressing the L5 nerve. A computed tomography scan was then ordered, confirming an extra-foraminal disc protrusion at the L5-S1 level, containing a focus of gas that was compressing the left L5 nerve root and communicating with the vacuum disc at L5-S1. After a failed left L5 transforaminal epidural steroid injection, the patient was brought back for a percutaneous intradiscal aspiration of the vacuum disc gas. This resulted in immediate relief for the patient. A follow-up MRI performed 2 months after the procedure found an approximate 25% reduction in the size of the vacuum disc herniation. Six months after the procedure, the patient remains free of radicular pain. This case report suggests that a percutaneous aspiration of gas from a vacuum disc herniation may assist in the treatment of radicular pain.

show abstract

Lumbar Zygapophysial Joint Radiofrequency Denervation: A Long-Term Clinical Outcome Study

Cited by 10 publications

References 39 publications

The Efficacy of Repeated Radiofrequency Medial Branch Neurotomy for Lumbar Facet Syndrome

The Efficacy of Repeated Radiofrequency Medial Branch Neurotomy for Lumbar Facet Syndrome

Repeat Percutaneous Radiofrequency Facet Joint Denervation for Chronic Back Pain: A Prospective Study

Percutaneous Intradiscal Aspiration of a Lumbar Vacuum Disc Herniation: A Case Report

Contact Info

Product

Resources

About