Percutaneous Radio-Frequency Neurotomy for Chronic Cervical Zygapophyseal-Joint Pain

Lord, Susan M.; Barnsley, Leslie; Wallis, Barbara J.; McDonald, Gregory J.; Bogduk, Nikolai

doi:10.1056/nejm199612053352302

Cited by 781 publications

(560 citation statements)

References 19 publications

(22 reference statements)

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“…Two studies reported some subsiding pain and numbness associated with the procedure [60,92]. The symptoms were more common and lasted longer in the radiofrequency lesion group.…”

Section: Adverse Effectsmentioning

confidence: 99%

Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review

et al. 2005

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“…Two studies reported some subsiding pain and numbness associated with the procedure [60,92]. The symptoms were more common and lasted longer in the radiofrequency lesion group.…”

Section: Adverse Effectsmentioning

confidence: 99%

Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review

et al. 2005

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“…Yang and King [30] observed that the lumbar facet joint under compression could cause the capsule to stretch. Clinically, facet denervation has long been employed in the management of cervical, thoracic and low-back pain [4,17,22,24 Abstract Facet joint capsules (FJC) may experience large mechanical deformation under spine motion. There has been no previous quantitative study of the relationship between capsular strain and sensory nerve activation in spine FJC in vivo.…”

Section: Introductionmentioning

confidence: 99%

Development of an in vivo method to investigate biomechanical and neurophysiological properties of spine facet joint capsules

et al. 2005

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IntroductionThe human spine provides substantial load-bearing capability and range of motion due to important properties of its tissues and structures. Among various spinal soft tissues, facet joint capsules (FJC) have been the focus of several research studies due to their important roles in physical activities and spine pathology. The vertebral column has a greater range of motion in the cervical and lumbar regions than in the thoracic region for flexion and extension, and the FJC may experience large mechanical deformation in these regions. Various biomechanical studies have implicated that the lower cervical FJC can stretch beyond their physiologic range under whiplash loading conditions [7,18,28]. Yang and King [30] observed that the lumbar facet joint under compression could cause the capsule to stretch. Clinically, facet denervation has long been employed in the management of cervical, thoracic and low-back pain [4,17,22,24 Abstract Facet joint capsules (FJC) may experience large mechanical deformation under spine motion. There has been no previous quantitative study of the relationship between capsular strain and sensory nerve activation in spine FJC in vivo. Space limitation in the cervical spine makes such a study difficult, as the facet joint must be loaded while simultaneously monitoring nerve discharge from nerve roots immediately adjacent to the loaded tissue. A new methodology was developed to investigate biomechanical and neurophysiological properties of spine facet joint capsules in vivo. The method incorporated a custom-fabricated testing frame for facet joint loading, a stereoimaging system, and a template-matching technique to obtain single afferent response. It was tested by loading goat C5-C6 FJC in vivo with simultaneous nerve root recordings and 3D strain tracking of the capsules. Preliminary data showed that 18 of 23 afferents (78.3%) were found to be mechanosensitive to tensile stretch, and five were not responsive, even under tensile load as high as 27.5 N. Mechanosensitive afferents in goat capsules had tensile strain thresholds of 0.119±0.080. Neural responses of all mechanosensitive units showed statistically significant correlations (all P<<0.05) with both capsular load (r 2 =0.744±0.109) and local strain (r 2 =0.868±0.088). This method enables the investigation of the correlation between tissue load, deformation and neural responses of mechanoreceptors in spine facet joint capsules, and can be adapted to investigate tissue loading and neural response of other soft tissues.

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“…Studies support the idea that RF denervation is a treatment of choice for initial pain relief; however, it does not produce permanent pain relief because the nerve eventually regenerates, usually within 12-18 months (North et al, 1994). Lord et al found the median time of return to 50% of pre-procedure pain was 263 days (Lord et al, 1996). Dreyfuss et al found that pain relief may last for about 12 months (Dreyfuss et al, 2000).…”

Section: Anatomy and Pathogenesis Of Facet Joints Painmentioning

confidence: 99%

Application of Radiofrequency in Low Back Pain Treatment

Tsou¹,

Kao²

2012

Low Back Pain Pathogenesis and Treatment

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Percutaneous Radio-Frequency Neurotomy for Chronic Cervical Zygapophyseal-Joint Pain

Abstract: In patients with chronic cervical zygapophyseal-joint pain confirmed with double-blind, placebo-controlled local anesthesia, percutaneous radio-frequency neurotomy with multiple lesions of target nerves can provide lasting relief.

Cited by 781 publications

References 19 publications

Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review

Outcome of invasive treatment modalities on back pain and sciatica: an evidence-based review

Development of an in vivo method to investigate biomechanical and neurophysiological properties of spine facet joint capsules

Application of Radiofrequency in Low Back Pain Treatment

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