Medial Branch Neurotomy in Management of Chronic Spinal Pain:
Systematic Review of the Evidence

Manchikanti, Laxmaiah; Singh, Sanjiv; Bd, Vilims; Hc, Hansen; Dm, Schultz; Ds, Kloth

doi:10.36076/ppj.2002/5/405

Cited by 78 publications

(7 citation statements)

References 77 publications

(100 reference statements)

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“…Also, Gofeld et al, reported that about 70% of patients maintained at least 50% pain relief for between 6 and 24 months. (13) The reviews of Boswell et al, and Manchikanti et al, provide strong evidence for short-term relief and moderate evidence for long-term relief (14,15). Moreover, Manchikanti et al, provided a strong recommendation for lumbar RF neurotomy (16).…”

Section: Resultsmentioning

confidence: 99%

Role of Radiofrequency in Management of Chronic Low Back Pain

Qenawy

El-Aziz²,

Mahmoud³

et al. 2022

Aswan University Medical Journal

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Background: Chronic low back pain (LBP) affects about 45% of the population, it is treated conservatively, and if failed, we use invasive methods, as radiofrequency neurotomy (RF). Objective: to evaluate the efficacy, safety, and outcome of RF in patients with chronic LBP. Patients and Methods: This prospective study included patients with chronic LBP lasting ≥3 months. We performed RF to the included participant, moreover, we assessed the chronic LBP by visual analogue score, the improvement of the daily activities, and the safety immediately after the procedure, after one week, after one month and after three months. Results: We included 40 patients with chronic LBP not responding to medical treatment. The average age was 58.28 ±7.2, 13 of them were male. The L4-L5-S1 levels were the most affected (67.5%). The pain score reduced from 8 before the operation to 3 after three months follow up p-value < 0.001. Regarding to Daily living activities, after 3 months the number of patients with normal daily activities was 50 %, and the number of supported patients still only 3 patients p-value < 0.001. Conclusion: RF showed promising results in the management of chronic LBP, it has advantages regarding the long term follow up.

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Section: Resultsmentioning

confidence: 99%

Role of Radiofrequency in Management of Chronic Low Back Pain

Qenawy

El-Aziz²,

Mahmoud³

et al. 2022

Aswan University Medical Journal

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“…Typische Zielregionen der Infiltration sind die dorsolateralen Crista iliaca, SIPS-Region und paraspinös segmentale Regionen. LA + GK: gut [1, 72], überlegen [74], positiv [77] nur LA: moderat [72] LA + GK: gut [6,105], moderat (nur KZ) [16,77], (LOR-Technik: schlecht [71]) nur LA: moderat [6] nur GK: schlecht [7,8], moderat [44] LA + GK: gut [5,10,60,74], moderat [61,78], Operationsvermeidung [76,78] nur LA: moderat [16,60,76] nur GK: schlecht [ [62,108], moderat [9] Gut [26], moderat [15,62,96], (gepulst limitiert, 1 non-RCT) ASIPP-Review, 1966-2011 [26] inkludiert: 25…”

Section: Neuraltherapeutische Infiltrationen Und Injektionen Beim Trsunclassified

“…:23 revidiert: 150 von 520 [ 10 , 60 ] inkludiert: 25, RCT: 15 revidiert: 117 von 428 BSV und/oder Radikulopathie LA + GK: gut LZ & KZ nur LA: moderat LA + GK: gut LZ & KZ nur LA: moderat LA + GK: gut LZ & KZ nur LA: moderat Diskogener oder axialer TRS LA + GK: gut LA + GK: gut nur LA: schlech t LA + GK: schlecht nur LA: schlecht Spinalstenose LA + GK: moderat LA + GK: moderat LA + GK: moderat „Post-surgery“-Syndrom LA + GK: moderat ? LA + GK: schlecht nur LA: schlecht Therapeutische lumbale Facettengelenksinterventionen (FGI) Technik: Intraartikuläre FGI „Medial-branch“-Block Radiofrequenzablation Reviews gesamt: (nur bildgestützt, Ausnahme LOR) Schlecht [ 15 , 26 , 62 , 96 , 108 ] LZ: gut [ 26 ], LZ: moderat [ 9 , 15 , 23 , 62 , 96 , 108 ] KZ: gut [ 62 , 108 ], moderat [ 9 ] Gut [ 26 ], moderat [ 15 , 62 , 96 ], ( gepulst limitiert , 1 non-RCT) ASIPP-Review, 1966–2011 [ 26 ] inkludiert: 25, RCT: 11, non-RCT 14 revidiert: 122 von 335 Positiv : 5 non-RCT ...…”

Section: Therapeutische Lokalinterventionen Beim Trs: Techniken Effek...unclassified

Therapeutische Injektion und Manuelle Medizin beim tiefen Rückenschmerz

Schütz

2022

Orthopäde

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Zusammenfassung Hintergrund Angelehnt an die zielorientierte Therapieplanung und -führung in der Versorgung chronisch Rheumakranker, plädiert der Autor bei Patienten mit (chronischem) degenerativem tiefem Rückenschmerz (TRS), orientiert an den differenzialtherapeutischen Grundsätzen der Manuellen Medizin (MM), und unter Kenntnis von Techniken und Evidenzen therapeutischer Lokalinfiltrationen (TLI), für die Etablierung eines strukturierten mechanismenbasierten Therapiekonzeptes im Sinne des „treat to target“ (T2T) im ambulanten schmerztherapeutischen Versorgungsbereich. Diagnostik Dies setzt eine konsequente (Primär‑)Diagnostik mit Schmerzanalyse unter der Prämisse, dass TRS, wenn strukturell-funktionell bedingt, immer spezifisch ist, voraus. Eine breite biopsychosoziale Anamnese und strukturbezogene klinisch-bildgebende (Ausschluss‑)Diagnostik mit funktioneller Differenzierung nach MM-Grundsätzen und ggf. interventionelle Blocks, sollten am Ende zur Formulierung einer 3‑Ebenen-Diagnose als Voraussetzung zu einer mechanismenbasiert-zielorientiert-hierarchischen Stufentherapie bei TRS führen. Diese wird in diesem Artikel pragmatisch fallorientiert, unter Implementierung von Techniken und Evidenzen der TLI und MM, vorgestellt.

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“…It is estimated that 24.4% of the population suffers from spinal cord compression, which affects the cervical cord in 10% of cases [ 3 ]. Tumors, infections, trauma, and degenerative changes such as intervertebral disc herniation, osteophytes, and ossification of the posterior longitudinal ligaments can all cause the cervical canal to narrow [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Morphometric Analysis of the Cervical Canal Using Computed Tomography Scan Among Patients With Neck Pain in North India

Jee¹,

Yadav²,

Kaul³

et al. 2022

Cureus

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Introduction Cervical spinal stenosis is a common disease that results in considerable morbidity and disability. To avoid long-term disability caused by irreversible spinal cord damage, quick diagnosis and treatment are required. To our knowledge, until recently, there has been no report or study evaluating the cervical canal stenosis and associated facet joint arthrosis as the major cause of neck pain, so the current study used computed tomography (CT) scans to determine the prevalence of cervical canal stenosis and facet joint osteoarthrosis in patients who presented with neck pain, including its relationship with age, sex, and cervical spinal levels (C3-C7). Methods The current clinical descriptive cross-sectional study was conducted in the Department of Anatomy and Radiodiagnosis at Santosh Medical College, Ghaziabad, for a period of 24 months among newly diagnosed outpatient department (OPD) cases of neck pain (18 years or older) with suspected cervical canal stenosis and facet joint arthrosis. Clinical history, patient-specific clinical examination, and relevant information were obtained in a structured data collection schedule through interviews during OPD hours. All of the participants underwent a CT scan of the cervical region. The independent factors (age, gender, height, and weight) were used in a multiple linear regression analysis of neck pain grading, Torg ratio (TR), and right and left facet joint degeneration, which were expressed as R-squared (R 2 ) and adjusted R-squared (aR 2 ). Statistical tests were executed at a 5% level of significance; an association was considered significant if the p-value was <0.05. Results A total of 83 subjects were enrolled in this study with equal representation from both sexes, i.e., males (49.4%) and females (50.6%). The transverse vertebral canal (T-VC) diameter was narrowest at the level of C3 (25.00 ± 1.13) and gradually increased at the level of C6 (25.18 ± 1.14) in this study. The mean TR of cervical vertebrae C3-C4 dropped gradually from C3 (0.78 ± 0.05) to C7 (0.76 ± 0.05) in this study. Severe left and right facet joint degeneration were observed in 13.3% and 10.5% of study subjects, respectively. In almost every subject, neck pain was a neurological symptom, so multiple linear regression analysis of neck pain grading was carried out with the independent variables (age, gender, height, and weight) and it was found to be not significant (R 2 = 0.0617, aR 2 = 0.0136, p = 0.2842). Conclusion The articulations of the posterior arch of the vertebrae are known as facet joints. They are a vital component of the vertebral column's structural stability. The superior and inner articular facets of the vertebrae are joined by these joints, which are encased in a fibrous capsule.

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Medial Branch Neurotomy in Management of Chronic Spinal Pain: Systematic Review of the Evidence

Cited by 78 publications

References 77 publications

Role of Radiofrequency in Management of Chronic Low Back Pain

Role of Radiofrequency in Management of Chronic Low Back Pain

Therapeutische Injektion und Manuelle Medizin beim tiefen Rückenschmerz

Morphometric Analysis of the Cervical Canal Using Computed Tomography Scan Among Patients With Neck Pain in North India

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