Lumbar spinal stenosis is one of most common pathologic conditions affecting the lumbar
spine. Pain and/or disability in the low back and lower extremities with or without neurogenic
claudication may occur as a result of compression of dural sac contents or nerve roots in
the narrowed space. Bulging and protrusion, facet joint hypertrophy, and disc herniation
combined with osteophytes and arthritic changes of facet joints can be the cause of lumbar
spinal stenosis. Medical/interventional treatment may be considered as an initial treatment for
patients with mild symptoms of lumbar spinal stenosis. Surgery is usually considered when
medical/interventional treatment has failed. Even though surgery has been considered to be
the definitive treatment for spinal stenosis conventionally, it has potential problems including
general anesthesia related complications and failed back surgery syndrome. For that reason,
minimally invasive techniques such as percutaneous endoscopic lumbar discectomy (PELD),
epiduroscopic laser neural decompression (ELND), and nucleoplasty with radiofrequency have
been developed as alternatives to surgery.
The authors present a case of treating lumbar spinal stenosis by using radiofrequency
thermocoagulation. Radiofrequency therapy is used for spinal pain, usually in forms of
neurotomy or nucleoplasty. The patient in this case had leg pain with neurogenic claudication
caused by lumbar spinal stenosis from facet joint hypertrophy. His pain did not respond to
conservative treatment including epidural steroid injection, but he didn’t want to get surgery. As
an alternative to surgery, we applied radiofrequency thermocoagulation with high temperatures
of electrode to the hypertrophied facet joint for the decompressing of the spinal nerve and the
patient’s pain was improved without any complications after the treatment.
Key words: Low back pain, neurogenic claudication, lumbar spinal stenosis, facet joint
hypertrophy, radiofrequency thermocoagulation, minimally invasive technique