Results of treatment of low lumbar pain syndrome by radiofrequency denervation of the facet joints
Keywords:spondylarthritis, low lumbar pain syndrome, radiofrequency denervation of facet joints
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.
2. Murray CJ, Barber RM, Foreman KJ, et al. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. The Lancet. 2015;386(10009):2145-91. [CrossRef] [PubMed] [PubMed Central]
3. Shpagin MV, Yastrebov DN, Voropayev AA, Pavlov SA. Usage of nonsteroidal anti-inflammatory oxicam drugs in treating dorsalgias. Meditsinskiy almanakh. 2011;1(14):145-7. Russian. [eLIBRARY.ru]
6. Weishaupt D, Zanetti M, Hodler J, Boos N. MR imaging of the lumbar spine: prevalence of intervertebral disk extrusion and sequestration, nerve root compression, end plate abnormalities, and osteoarthritis of the facet joints in asymptomatic volunteers. Radiol. 1988;209(3): 661-6. [CrossRef] [PubMed]
7. Dolgova LN, Krasivina IG, Kirillov NV. Facet arthropathies: selected issues of nomenclature, diagnosis, and therapy. RMZh Rheumatology. 2016;2:77-84. Russian. [eLIBRARY.ru]
8. Spirin NN, Kiselev DV. Problema khronicheskoy boli v spine: fasetochnyy sindrom [The low back pain problem: faceted syndrome]. RMZh. 2015;(23)17: 1025-30. [eLIBRARY.ru]
9. Nazarenko GI, Cherkashov AM, Shevelev IN, Kuymin VI, Konovalov NA, Nazarenko AG, et al. Effectiveness of one-stage microdiscectomy and radiofrequency denervation of intervertebral joints compared to microdiscectomy in patients with spinal discs herniation. Zh Vopr Neirokhir Im N N Burdenko 2014;78(6):4-8 Russian. [CrossRef] [PubMed]
11. Volkov IV, Parfenov VE, Karabaev ISh. Opyt ispol’zovaniya vysoko-chastotnoy denervatsii fasetochnykh sustavov v lechenii degenerativno-distroficheskikh zabolevaniy pozvonochnika. Neyrokhirurgiya i nevrologiya Kazakhstana. 2012;27-28(2-3):46. Available from: http://www.neurojournal.kz/journal-archive/2.3-(27.28)-2012.html.
12. Kolotov EB, Kolotova EV, Elagin SV, Aminov RR, Kuz’mich MP. The combination of referred pain syndromes because of spondyloarthrosis with non-compressive cervical and lumbar syndroms. Neyrokhirurgiya. 2014;(4): 38-43. Russian. [eLIBRARY.ru]
13. Tyulikov KV, ManukovskyVA, Litvinenko IV, Korostelev KE, Badalov VI. Minimally invasive treatment for radicular pain syndrome caused by degenerative lumbar spine disease. Vestnik rossiyskoy voyenno-meditsinskoy akademii. 2013;(1):1-7. Russian. [eLIBRARY.ru]
14. Konovalov NA, Proshutinskiĭ SD, Nazarenko AG,KorolishinVA.[Radiofrequency denervation of intervertebral joints in management of facet pain syndrome]. Zh Vopr Neirokhir Im N N Burdenko. 2011;75(2):51-5; discussion 55. Russian. [PubMed]
15. Leclaire R, Fortin L, Lambert R. Radiofrequency facet joint denervation in the treatment of low back pain: a placebo-controlled clinical trial to assess efficacy. Spine. 2001 Jul 1;26(13):1411-6. [CrossRef] [PubMed]
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