Percutaneous Radiofrequency Neurotomy in the Treatment of Cervical Zygapophysial Joint Pain

Lord, Susan M.; Barnsley, Leslie; Bogduk, Nikolai

doi:10.1097/00006123-199504000-00014

Cited by 76 publications

(144 citation statements)

References 7 publications

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“…Pain relief may be seen to diminish in studies with very long followup periods. Lord, et al, 24 demonstrated that nerve regeneration can lead to pain recurrence only a few months after the procedure.…”

Section: Discussionmentioning

confidence: 99%

Kryorhizotomy: an alternative technique for lumbar medial branch rhizotomy in lumbar facet syndrome

Bärlocher¹,

Krauss²,

Seiler³

2003

Journal of Neurosurgery: Spine

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Object. The authors conducted a prospective study to investigate the efficacy of kryorhizotomy, an alternative procedure for lumbar medial branch neurotomy, in the treatment of lumbar facet syndrome (LFS). Methods. Fifty patients with chronic low-back pain, in whom pain was relieved by controlled diagnostic medial branch blocks of the lumbar zygapophyseal (facet) joints, underwent lumbar medial branch kryorhizotomy. Outcome was evaluated using the Visual Analog Pain Scales and assessment of work capacity. All outcome measures were repeated at 6 weeks, 6 months, and 1 year after surgery. At 1-year follow-up examination, 31 (62%) of 50 patients experienced a good response to lumbar facet kryorhizotomy. Good results with pain relief of 50% or more were obtained in 85% of patients without previous spinal surgery but only in 46% who had undergone previous spinal surgery. This difference was statistically significant. In five patients (16%) in whom a good initial benefit was observed but who experienced increased pain within 6 weeks after kryorhizotomy, the beneficial result was regained after an early repeated procedure. There were no side effects. Overall, 19 (38%) of 50 procedures were not considered successful. In six of these 19 cases a rigid stabilization of the involved segment provided permanent pain relief. Conclusions. Based on this study, patients with LFS who have not undergone previous spinal surgery benefit significantly from percutaneous lumbar kryorhizotomy. Kryorhizotomy, which has virtually no risk, seems to be a valuable alternative technique to lumbar medial branch neurotomy.

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Section: Discussionmentioning

confidence: 99%

Kryorhizotomy: an alternative technique for lumbar medial branch rhizotomy in lumbar facet syndrome

Bärlocher¹,

Krauss²,

Seiler³

2003

Journal of Neurosurgery: Spine

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“…Other reports have mentioned that this technique appears to be effective for relief of pain derived from facet joints when repeated (20)(21)(22). However, none of the three reports cited here included a formal analysis of clinical outcomes of repeat RFJD, and all of these papers dealt specifically with the cervical area.…”

Section: Introductionmentioning

confidence: 97%

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

Zotti

Osti

2010

Journal of Musculoskeletal Pain

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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.

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“…This substantial increase in lesion size may assist in increasing the likelihood and extent of nerve ablation using monopolar RFA. 7,8 This in vivo study also challenges some previous recommendations based on ex vivo data. First, the preinjection of 1%L alone did not substantially enhance lesion size in comparison to NF, as was seen in previous ex vivo studies.…”

Section: Discussionmentioning

confidence: 67%

“…5 The targeted nerves are small (<1-to 2-mm diameter for medial branch ablation, depending on the spinal level) and cannot be visualized with fluoroscopy. [6][7][8] Bony anatomy is used as a surrogate marker for nerve location and radiofrequency (RF) needle placement, which can be imprecise because of interpatient variability in nerve location. In addition, RF lesion size has been limited with conventional pain medicine RF equipment and methods.…”

mentioning

confidence: 99%

Hypertonic Sodium Chloride Preinjectate Increases In Vivo Radiofrequency Ablation Size

Provenzano¹,

Cosman

Wilsey

2018

Regional Anesthesia and Pain Medicine

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Percutaneous Radiofrequency Neurotomy in the Treatment of Cervical Zygapophysial Joint Pain

Cited by 76 publications

References 7 publications

Kryorhizotomy: an alternative technique for lumbar medial branch rhizotomy in lumbar facet syndrome

Kryorhizotomy: an alternative technique for lumbar medial branch rhizotomy in lumbar facet syndrome

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

Hypertonic Sodium Chloride Preinjectate Increases In Vivo Radiofrequency Ablation Size

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