Results of treatment of low lumbar pain syndrome by radiofrequency denervation of the facet joints

Mykola V. Kvasnitskyi

Abstract


Background. The high prevalence of degenerative-dystrophic spine injury and low effectiveness of spondyloarthritis therapy makes relevant the treatment of low lumbar pain syndrome caused mainly by spondyloarthritis by innovative minimally invasive method of high-frequency denervation of facet joints.

Purposes. To determine the effectiveness of the radiofrequency denervation of facet joints, taking into account early and long-term results of treatment, to eliminate the pain syndrome in patients with lower lumbar pain syndrome with predominating spondyloarthritis.

Materials and methods. The early and long-term results of treatment by the method of high-frequency denervation of facet joints were analyzed using 1RFG-1A/RFG-1B (produced by Radionics) in 136 patients (73 men and 63 women aged from 44 to 81 years) with lower lumbar pain syndrome with the leading clinical manifestation of arthrosis of the articular joints. The pain syndrome was assessed four times – in the preoperative and postoperative periods (during the week), 3 months and a year after treatment. The visual analogue scale (VAS) of pain and the Oswestry index of disability index were used. The control group consisted of 31 patients (15 women and 16 men aged from 42 to 83 years) with lower lumbar pain with spondyloarthrosis dominating, which were treated non-operatively.

Results. Immediately after treatment, a reliable result of treatment of chronic low-back pain syndrome in the basic and control groups with all structural and morphological changes of the spine was obtained both by the Oswestry disability scale and the visual analogue scale of pain (except the control group where spondyloarthritis was combined with large herniated discs, spinal stenosis, spondylolisthesis). Meanwhile there is clear and reliable difference between the basic group and the control group immediately after the treatment. After three months and a year after the treatment in both groups a reliable result was obtained only in the basic group, which indicates high efficiency of radiofrequency denervation of facet joints.

Conclusions. Both early and long-term treatment results demonstrate efficacy and safety of high-frequency denervation of facet joints in patients with lower lumbar pain syndrome with spondyloarthrosis dominating. High-frequency denervation of facet joints should be included in the algorithm of treatment of facet syndrome in case of the ineffectiveness of drug treatment.


Keywords


spondylarthritis; low lumbar pain syndrome; radiofrequency denervation of facet joints

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DOI: https://doi.org/10.25305/unj.112096

Copyright (c) 2017 Mykola V. Kvasnitskyi

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