Percutaneous lumbar zygapophysial (Facet) joint neurotomy using radiofrequency current, in the management of chronic low back pain: a randomized double-blind trial

Sherdil Nath, Christine Ann Nath, Kurt Pettersson
Spine 2008 May 20, 33 (12): 1291-7; discussion 1298

STUDY DESIGN: A randomized controlled study of percutaneous radiofrequency neurotomy was conducted in 40 patients with chronic low back pain (20 active and 20 controls).

OBJECTIVE: The aim of the study was to evaluate the possible beneficial effect of percutaneous radiofrequency zygapophysial joint neurotomy in reducing pain and physical impairment in patients with pain from the lumbar zygapophysial joints, selected after repeated diagnostic blocks.

SUMMARY OF BACKGROUND DATA: Facet or zygapophysial joint pain may be one of the causes of chronic low back pain and may be treated by a percutaneous radiofrequency denervation. Patients may possibly be identified by a positive diagnostic block. These blocks need to be repeated as false positive responses to single blocks occur.In all previous studies patients treated with radiofrequency denervation have been selected after single diagnostic blocks resulting in a varying degree of relief.

METHODS: All patients were examined by an orthopedic surgeon before and 6 months after the treatment (sham or active). Inclusion criteria were 3 separate positive facet blocks. Denervation was achieved by multiple lesions at each level in an effort to provide effective denervation.

RESULTS: The active treatment group showed statistically significant improvement not only in back and leg pain but also back and hip movement as well as the sacro-iliac joint test. Pre operative sensory deficit and weak or absent ankle reflex normalized (P < 0.01) and (P < 0.05), respectively. There was significant improvement in quality of life variables, global perception of improvement, and generalized pain.The improvement seen in the active group was significantly greater then that seen in the placebo group with regard to all the above-mentioned variables. None of our patients had any complication other than transient postoperative pain that was easily managed.

CONCLUSION: Our study indicates that radiofrequency facet denervation is not a placebo and could be used in the treatment of carefully selected patients with chronic low back pain.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"