Background: Zygapophysial joint arthrosis is a pathology related with axial lumbar pain. The
most accepted treatment, after failure of medical management, is the thermal denervation
of the medial branch. Nonetheless, the placement of the heat probe remains a challenge to
surgeons, even when using the fluoroscope. Using a variation of Shealy’s and Bogduk’s original
techniques, which includes ablation of the medial branch and the nerves present in the joint
capsule, we hypothesize that we can obtain similar outcomes to those found in the literature.
Objective: To present the results attained over the last 8 years in the treatment of axial
lumbar pain from zygapophysial joints degeneration, by employing a variation of the lumbar
medial branch neurotomy technique, called 360-degree facet rhizotomy with radiofrequency.
Study Design: Retrospective evaluation.
Setting: Spine Center – Minimally Invasive Surgery in Bogotá, Colombia.
Methods: A medical chart review was conducted for patients diagnosed with axial lumbar
pain from zygapophysial joint arthrosis and treated with 360-degree facet rhizolysis with a high
frequency radiofrequency energy source between 2008 and 2014. Data were evaluated under
modified MacNab and pre- and postoperative visual analog scale (VAS) criteria.
Results: We obtained a total of 73 patients. The average population age was 58.6 years. The
preoperative VAS obtained was 7.3, which changed to 1.7 one year after the procedure. The
MacNab criteria 12 months after the surgery gave satisfactory outcomes (excellent and good)
from 91.7% of the patients.
Limitations: This retrospective study includes inherent limitations and only offers one year
follow-up data.
Conclusions: Thermal therapy for zygapophysial joint arthrosis constitutes a safe and
effective technique. The one year follow-up data presented here show that the ablation of
the medial branch and nerves present in the joint capsule leads to satisfactory results in a high
percentage of patients.
Key words: Zygapophysial joint, lumbar axial pain, high frequency radiofrequency, facet
arthrosis, neurolysis, thermal therapy, facet joint thermocoagulation