Radiofrequency Denervation of the Lumbar Zygapophysial Joints—Targeting the Best Practice

Gofeld, Michael; Faclier, Gil

doi:10.1111/j.1526-4637.2007.00345.x

Cited by 98 publications

(150 citation statements)

References 15 publications

Supporting

Mentioning

137

Contrasting

Unclassified

Order By: Relevance

“…According to results of several clinical trials, RF denervation of lumbar facet joints seems to be a very effective therapy with a success rate of 43-87% after 1 year [7,12,13]. Compared to those trials, 22% success rate of our study in 1 year after therapy is disappointing.…”

Section: Discussioncontrasting

confidence: 46%

“…The highest long-term success rate (87%) was achieved by a study which included only patients with a BDI \ 17 and without previous surgery [7]. In a more recent larger study, in which patients with previous surgery were excluded, the success rate decreased much faster within 1 year to 47% [12]. In this study, the influence of depression on the results was not evaluated.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Factors determining the success of radiofrequency denervation in lumbar facet joint pain: a prospective study

et al. 2011

View full text Add to dashboard Cite

Background and aims Radiofrequency denervation (RF) of the lumbar facet joints has been shown to be effective in well-selected patients. However, long-term success varies between studies. We evaluated the influence of selected psychosocial and constitutional factors on the outcome of RF, expressed as the duration of pain relief. Methods This prospective observational study included 44 patients who received RF denervations at the University Hospital of Berne. Success was defined as at least 50% pain reduction 7-21 days, 6 months and 1 year after RF therapy. The Cox-regression analysis was performed to evaluate the influence of the following factors on the duration of success: age, sex, depression, work inability and previous surgery. Results Complete follow-up was available for 41 patients. The success rate 7-21 days after the denervation was 76%. It decreased to 32% at 6 months and to 22% at 1 year. The median success duration was 17 weeks (95% CI 10-26). The Cox-regression analysis showed a significant shorter duration of success for patients with depression (hazard ratio [HR] 2.97, 95% CI 1.32-6.65), previous surgery (HR 2.39, 95% CI 1.10-5.21) and number of treated joints (HR 1.95 for each increase in the number of joints, 95% CI 1.14-3.33). In bivariate analyses, only depression was kept to be significant.Conclusions Depression seems to be related with a short duration of success. Based on these findings, a comprehensive study is warranted to evaluate whether psychosocial factors have to be considered when recruiting patients for radiofrequency denervation.

show abstract

Section: Discussioncontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Factors determining the success of radiofrequency denervation in lumbar facet joint pain: a prospective study

et al. 2011

View full text Add to dashboard Cite

show abstract

“…In the study by Gofeld et al (14), only the patients with an appropriate response to comparative double diagnostic blocks were evaluated and 55 of the 174 patients (31.6%) experienced no benefit from the RF procedure, 119 patients (68.4%) had well to excellent pain relief lasting from 6 to 24 months. They concluded that proper patient selection and anatomically correct FJRFs provides strong short-term and moderate longterm pain relief.…”

Section: Civelek E Et Al: Facet Joint Injection and Radiofrequency Dmentioning

confidence: 99%

Comparison of effectiveness of facet joint injection and radiofrequency denervation in chronic low back pain

Çivelek¹,

Cansever²,

Kabataş³

et al. 2011

Turkish Neurosurgery

View full text Add to dashboard Cite

AIm:The study was conducted to compare the clinical effectiveness of FJ injections (FJI) and FJ radiofrequency (FJRF) denervation in patients with chronic low back pain. mAterIAl and methOds:This study included 100 patients; 50 in FJI 50 in FJRF group. VNS, NASS and EQ-5D were used to evaluate the outcomes. All outcome assessments were performed at baseline, 3 months, 6 months and 12 months. results: FJI in early post-op but FJRF in 1st, 6th and 12th month VNS showed better results (p<0.001). There was no significant difference in the 1st (p=1) and 6th month (p=0.13) but in 12th month (p=0.04) in NASS. Increase in level number showed positive effect in NASS in FJRF group (p=0.018) but no effect in FJI group (p=0.823) in the 12th month follow-up. There was no significant difference with respect to 1st month (p=0.17), 6th month (p=0.22) and 12th month (p=0.11) post-procedure follow-ups in EQ-5D. At the short term FJI was more effective than FJRF however in midterm follow-up FJRF had more satisfying results than FJRF.COnClusIOn: To our knowledge, the first choice should be the FJI and if pain reoccurs after a period of time or injection is not effective, RF procedure should be used for the treatment of chronic lumbar pain.KeywOrds: Facet, Joint, Injection, Radiofrequency, Denervation, Low back pain ÖZ AmAÇ: Lomber faset eklem (FE) bozuklukları kronik bel ağrılarının en sık sebebidir. Bu çalışmada, kronik bel ağrılı hastalarda uygulanan FE enjeksiyonu (FEE) ve radyofrekans denervasyonunun (FER) klinik sonuçlarının karşılaştırılması amaçlamaktadır. yÖntem ve GereÇler: Bu çalışmaya 50 FEE ve 50 FER yapılan 100 hasta dahil edildi. VNS, NASS ve EQ-5D sonuçların değerlendirilmesi amacıyla kullanıldı. Sonuçlar başlangıç, 3. ay, 6. ay ve 12. aylarda elde edildi.BulGulAr: FEE işlem sonrası erken dönemde, FER ise 1., 6. ve 12. ayda daha etkiliydi (p<0,001). NASS sonuçlarında 1. (p=1) ve 6. ayda (p=0.13) anlamlı fark yokken 12. ayda (p=0,04) vardı. İşlem yapılan segment sayısı FER grubunun (p=0,018) 12. aydaki NASS sonucunu pozitif yönde etkilerken FEE grubunda (p=0,823) etkisi yoktu. EQ-5D sonuçları açısından 1. (p=0,17), 6. (p=0,22) ve 12. ayda (p=0,11) iki grup arasında anlamlı fark saptanmadı. Kısa dönemde FEE daha etkiliyken orta dönemde FER'in sonuçları daha başarılıydı. sOnuÇ: Faset eklemden kaynaklanan bel ağrılarında, FEE ve FER birer tedavi seçenekleridir. Sonuçlarımıza göre, kronik bel ağrısının tedavisinde FEE ilk seçenek olarak düşünülmeli ve bir süre sonra tekrarlayan veya FEE etkili olmadığı durumlarda FER tedavi amacıyla kullanılmalıdır.

show abstract

“…Interventional management of facet arthropathy is done through injection of local anaesthetic (with or without steroid) either within the joint (intra-articular injection) or on to the medial branches [26,31,[35][36][37][38][39][40]. Once diagnosis is confirmed, radiofrequency ablation (RFA) of medial nerves is done for long term effect.…”

Section: Interventional Management Of Facet Painmentioning

confidence: 99%

Low Back Pain due to Lumbar Facet Joint Arthropathy and its Management

Jadon¹

2016

Gen Med (Los Angeles)

View full text Add to dashboard Cite

Low back pain is a very common problem which brings a patient to orthopedic clinic or pain clinic. It is estimated that it affects about 60-80% of general population in the whole life and facet joints are responsible for back pain in 15%-45% of such cases. Multimodal approach including analgesics and back strengthening exercise are primary treatments. However, sustained relief can be achieved by radiofrequency ablation after proper diagnosis.

show abstract

Radiofrequency Denervation of the Lumbar Zygapophysial Joints—Targeting the Best Practice

Cited by 98 publications

References 15 publications

Factors determining the success of radiofrequency denervation in lumbar facet joint pain: a prospective study

Factors determining the success of radiofrequency denervation in lumbar facet joint pain: a prospective study

Comparison of effectiveness of facet joint injection and radiofrequency denervation in chronic low back pain

Low Back Pain due to Lumbar Facet Joint Arthropathy and its Management

Contact Info

Product

Resources

About