Abstract
Background and Study Aims Low back pain is well documented as an extremely common health problem. The most
frequently used treatment is radiofrequency denervation for chronic low back pain.
However, different clinical studies could only show a limited to no improvement regarding
the decrease of pain intensity and duration of the effect. The main reasons for these
limited effects seem to be due to the size of the lesion and difficulties in locating
the exact placement of the cannula near the medial branch as well as or additional
pathologies. Using an endoscope, it is possible to coagulate the facet joints and
the medial branch under visual control and consider other pathologies such as extraspinal
synovial cysts.
Patients In this retrospective study, we included 28 patients with low back pain, with a duration > 6
months and a 50% pain reduction on the numeric analog scale (NAS) after a diagnostic
block. All patients received endoscopic facet joint denervation of three facets on
the left and right side using only one incision on each side with an exploration of
the surrounding tissue. Telephone interviews were conducted with all patients. The
outcome was determined with Odom's criteria, percentage reduction NAS, subjective
assessment of the patient, and duration of the effect.
Results According to Odom's criteria, 68% of the patients showed “acceptable” to “excellent”
results and confirmed that denervation helped them manage their daily lives better.
The average pain reduction in the responder group was 47% with an average duration
of 7.8 months.
Conclusion In this retrospective study, we demonstrated the practicability and effectiveness
of the endoscopic facet joint denervation procedure in the treatment of chronic low
back pain using only one incision for three facets. Further studies should investigate
if this procedure is more effective than percutaneous radiofrequency denervation.
Keywords
facet joint syndrome - facet joint denervation - radiofrequency - rhizotomy - spinal
endoscopy
