Chronic axial lower back pain is one of the most common conditions that patients seek
medical attention for in pain practices. About 15 to 40% of axial lower back pain
is due to facet-mediated pain. Diagnostic blocks of the medial branch reliably identify
the facet joint as the pain generator and offer a prognostic factor for response to
radiofrequency neurotomy of the identified facet joints resulting in profound pain
relief. However, deep brain stimulation implants have been considered a contraindication
for neurotomy. We present an illustrative case of a patient with deep brain stimulation
system treated with bipolar medial branch neurotomy using a two-needle technique.
Keywords
chronic neuropathic back and leg pain - spinal surgery - deep brain stimulation -
thermal radiofrequency ablation
