Abstract
Chronic lower back pain (CLBP) without radiating symptoms has been a consistent challenge for physicians to diagnose and treat. Lumbar facetogenic pain prevalence range from 15% in the younger patients to 40% in the elderly. Medial branch blocks and percutaneous radiofrequency rhizotomy have many shortcomings the main issue being that these procedures typically do not provide consistent long lasting pain relief. Endoscopic rhizotomy can provide better and more consistent long term relief for patients with chronic lower back pain. We describe the surgical indications, technique, surgical pearls and our 5 year follow-up data on patients after performing Endoscopic rhizotomy to improve CLP.
Similar content being viewed by others
References
Bogduk NBL. Back pain and neck pain: an evidence-based update. Seattle: IASP Press; 1999.
Borenstein D. Does osteoarthritis of the lumbar spine cause chronic low back pain? Curr Pain Headache Rep. 2004;8:512–7.
Boswell MV, Shah RV, Everett CR, et al. Interventional techniques in the management of chronic spinal pain: evidence-based practice guidelines. Pain Physician. 2005;8:1–47.
Dreyer SJ, Dreyfuss PH. Low back pain and zygapophysial (facet) joints. Arch Phys Med Rehabil. 1996;77:290–300, Jackson RP. The facet syndrome: myth or reality? Clin Orthop. 1992;279:110–21.
Ghormley RK. Low back pain with special reference to the articular facet, with presentation of operative procedure. JAMA. 1933;101:1773–7.
Kuslich SD, Ulstrom CL, Michael CJ. The tissue origin of low back pain and sciatica: a report of pain response to tissue stimulation during operations on the lumbar spine using local anesthesia. Orthop Clin North Am. 1991;22:181–7.
Manchikanti L, Singh V, Pampati V, et al. Evaluation of the relative contributions of various structures in chronic low back pain. Pain Physician. 2001;4:308–16.
Marks RC, Houston T, Thulbourne T. Facet joint injection and facet nerve block: a randomized comparison in 86 patients with chronic low back pain. Pain. 1992;49:325–8.
Mooney V, Robertson J. The facet syndrome. Clin Orthop. 1976;115:149–56.
Schwarzer AC, Aprill CN, Derby R, et al. Clinical features of patients with pain stemming from the lumbar zygapophysial joints: Is the lumbar facet syndrome a clinical entity? Spine. 1994;19:1132–7.
Schwarzer AC, Wang S, Bogduk N, et al. Prevalence and clinical features of lumbar zygapophysial joint pain: a study in an Australian population with chronic low back pain. Ann Rheum Dis. 1995;54:100–6.
Sehgal N, Shah RV, McKenzie-Brown A, et al. Diagnostic utility of facet (zygapophysial) joint injections in chronic spinal pain: a systematic review of evidence. Pain Physician. 2005;8:211–24.
Shealy CN. The role of the spinal facets in back and sciatic pain. Headache. 1974;14:101–4.
Dreyfuss P, Halbrook B, Pauza K, et al. Efficacy and validity of radiofrequency neurotomy for chronic lumbar zygapophysial joint pain. Spine (Phila Pa 1976). 2000;25(10):1270–7.
Cohen SP, Raja SN. Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. Anesthesiology. 2007;106(3):591–614, Review.
Cohen SP, Stojanovic MP, Crooks M, et al. Lumbar zygapophysial (facet) joint radiofrequency denervation success as a function of pain relief during diagnostic medial branch blocks: a multicenter analysis. Spine J. 2008;8(3):498–504, Epub 2007 Jun 18.
Copay AG, Martin MM, Subach BR, et al. Assessment of spine surgery outcomes: inconsistency of change amongst outcome measurements. Spine J. 2010;10(4):291–6.
Klessinger S. Radiofrequency neurotomy for treatment of low back pain in patients with minor degenerative spondylolisthesis. Pain Physician. 2012;15(1):E71–8.
Dreyfuss PH, Dreyer SJ, NASS. Lumbar zygapophysial (facet) joint injections. Spine J. 2003;3(3 Suppl):50S–9. Review.
Yilmaz C, Kabatas S, Cansever T, et al. Radiofrequency facet joint neurotomy in treatment of facet syndrome. J Spinal Disord Tech. 2010;23(7):480–5.
Nath S, Nath CA, Pettersson K. Percutaneous lumbar zygapophysial (Facet) joint neurotomy using radiofrequency current, in the management of chronic low back pain: a randomized double-blind trial. Spine. 2008;33:1291–7. doi:10.1097/BRS.0b013e31817329f0.
Haufe SM, Mork AR. Endoscopic facet debridement for the treatment of facet arthritic pain – a novel new technique. Int J Med Sci. 2010;7(3):120–3.
Kornick C, Kramarich SS, Lamer TJ, et al. Complications of lumbar facet radiofrequency denervation. Spine (Phila Pa 1976). 2004;29(12):1352–4.
Manchikanti L, Pampati S, Cash KA. Making sense of the accuracy of diagnostic lumbar facet joint nerve blocks: an assessment of the implications of 50 % relief, 80 % relief, single block, or controlled diagnostic blocks. Pain Physician. 2010;13(2):133–43.
Deyo RA, Bass JE. Lifestyle and low back pain: the influence of smoking and obesity. Spine. 1989;14:501–6.
Hoogendoorn WE, Bongers PM, de Vet HC, et al. Flexion and rotation of the trunk and lifting at work are risk factors for low back pain: results of a prospective cohort study. Spine (Phila Pa 1976). 2000;25(23):3087–92.
Vogt MT, Hanscom B, Lauerman WC, et al. Influence of smoking on the health status of spinal patients: the National Spine Network database. Spine (Phila Pa 1976). 2002;27(3):313–9.
Vogt MT, Nevitt MC, Cauley JA. Back problems and atherosclerosis. Spine. 1997;22:2741–7.
Gofeld M, Jitendra J, Faclier G. Radiofrequency denervation of the lumbar zygapophysial joints: 10-year prospective clinical audit. Pain Physician. 2007;10(2):291–300.
Mikeladze G, Espinal R, Finnegan R, et al. Pulsed radiofrequency application in treatment of chronic zygapophyseal joint pain. Spine J. 2003;3(5):360–2.
Lindner R, Sluijter ME, Schleinzer W. Pulsed radiofrequency treatment of the lumbar medial branch for facet pain: a retrospective analysis. Pain Med. 2006;7(5):435–9.
Ostelo RW, de Vet HC. Clinically important outcomes in low back pain. Best Pract Res Clin Rheumatol. 2005;19(4):593–607, Review.
Bogduk N. Evidence-informed management of chronic low back pain with facet injections and radiofrequency neurotomy. Spine J. 2008;8(1):56–64, Review.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this entry
Cite this entry
Hayes, V.M., Siddiqi, F.N., Romero, J.M. (2015). Endoscopic Rhizotomy. In: Scuderi, G., Tria, A. (eds) Minimally Invasive Surgery in Orthopedics. Springer, Cham. https://doi.org/10.1007/978-3-319-15206-6_110-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-15206-6_110-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Online ISBN: 978-3-319-15206-6
eBook Packages: Springer Reference MedicineReference Module Medicine