Evaluation of endoscopic dorsal ramus rhizotomy in managing facetogenic chronic low back pain

Li, Zhenzhou; Hou, Shuxun; Shang, Wei-lin; Song, Kun; Wu, Wenwen

doi:10.1016/j.clineuro.2014.08.014

Cited by 21 publications

(18 citation statements)

References 29 publications

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“…Due to these variations, different RFA target locations and techniques have been proposed to overcome this difficulty [16, 17]. Endoscopic radiofrequency ablation has been utilized in the treatment of facetogenic CLBP in a number of clinical reports with favorable results [18–20], but to our knowledge, the efficacy of this technique when applied to SIJ-associated CLBP has not been reported. In this study, we utilized endoscopy for the precise ablation of potential pain generators associated with the SIJ and evaluated the clinical efficacy of this new technique.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Radiofrequency Ablation of the Sacroiliac Joint Complex in the Treatment of Chronic Low Back Pain: A Preliminary Study of Feasibility and Efficacy of a Novel Technique

Choi¹,

Kim

Ryu

et al. 2016

BioMed Research International

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Background. Radiofrequency ablation (RFA) is a less invasive technique for treatment of sacroiliac joint (SIJ) pain. Objective. To evaluate the feasibility and efficacy of endoscope-guided RFA for the treatment of CLBP from the SIJ complex. Methods. In this retrospective study, the medical records of 17 patients who underwent endoscope-guided RFA of the SIJ complex were reviewed. A bipolar radiofrequency probe was used to lesion the posterior capsule of the SIJ as well as the lateral branches of S1, S2, S3, and the L5 dorsal ramus in multiple locations. We visualized the ablation area using endoscope. We assessed visual analogue scale (VAS) and the Oswestry disability index (ODI) preoperatively, immediately postop, and at 1-, 3-, and 6-month postop outpatient clinic visits. Patient satisfaction of the procedure was assessed in percentages. Results. The mean duration of operation was 20 to 50 minutes. The mean VAS and the ODI scores decreased significantly immediately after the procedure and were kept significantly lower than baseline levels during the follow-up periods. No complications occurred perioperatively and during the follow-up periods. 88.6% of patients were satisfied with the procedure. Conclusions. Our preliminary results suggest that endoscope-guided RFA may be alternative option to treat CLBP secondary to SIJ complex.

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Section: Introductionmentioning

confidence: 99%

Endoscopic Radiofrequency Ablation of the Sacroiliac Joint Complex in the Treatment of Chronic Low Back Pain: A Preliminary Study of Feasibility and Efficacy of a Novel Technique

Choi¹,

Kim

Ryu

et al. 2016

BioMed Research International

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“…14 Li et al showed good to excellent outcomes in 97.8% of their patients after 1 year. 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.…”

Section: Discussionmentioning

confidence: 74%

“…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%

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

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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.

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“…This clinical observation is supported by peer-reviewed publication. No publication have refuted the documented results [5,6]. Modifications of the surgical technique over the years is aided by improved instrumentation endoscopic translaminar and transforaminal surgical techniques so that a "full endoscopic technique or combined surgical technique is possible.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Decompression, Foraminalplasty and Dorsal Rhizotomy for Foraminal Stenosis and Lumbar Spondylosis: A Hybrid Procedure in Lieu of Fusion

Yeung¹

2016

J Neurol Disord

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Surgical Treatment of chronic Low Back pain syndrome from an aging spine traditionally focuses on fusion as the ultimate surgical means to eliminate debilitating back pain and sciatica." A variety of painful degenerative conditions of the lumbar spine is treated surgically by translaminar decompression and fusion. Spine surgeons trained to perform fusions, with no training in endoscopic surgery are battling an economic crisis of escalating cost and affordability when fusion surgery is recommended for chronic back pain. This is considered the ultimate treatment by surgeons favoring fusion as a means to treat perceived or actual instability and/or deformity supported by imaging studies.

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Evaluation of endoscopic dorsal ramus rhizotomy in managing facetogenic chronic low back pain

Cited by 21 publications

References 29 publications

Endoscopic Radiofrequency Ablation of the Sacroiliac Joint Complex in the Treatment of Chronic Low Back Pain: A Preliminary Study of Feasibility and Efficacy of a Novel Technique

Endoscopic Radiofrequency Ablation of the Sacroiliac Joint Complex in the Treatment of Chronic Low Back Pain: A Preliminary Study of Feasibility and Efficacy of a Novel Technique

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

Endoscopic Decompression, Foraminalplasty and Dorsal Rhizotomy for Foraminal Stenosis and Lumbar Spondylosis: A Hybrid Procedure in Lieu of Fusion

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