Open Endoscopic Rhizotomy

2018 ◽  
Author(s):  
Raj J. Gala ◽  
Lauren Szolomayer ◽  
James Yue
Keyword(s):  
Back Pain ◽  
Medial Branch ◽  
Facet Joints ◽  
Endoscopic Techniques ◽  
Pathologic Anatomy ◽  
Provide Pain Relief ◽  
Dorsal Rami ◽  
Lumbar Facet ◽  
Lumbar Facet Joints

The etiology of axial low back pain is multifactorial and includes pain arising from lumbar facet joints. The facet joints, capsules, and surrounding tissues are innervated by the medial branches of the dorsal rami. Rhizotomy of these nerves can provide pain relief in patients with lumbar facetogenic pain. The reported benefits of endoscopic approaches to the spine include minimal disruption of nonpathologic anatomy while simultaneously allowing for improved visualization of pathologic anatomy. Endoscopic techniques have been described for spinal stenosis, disc herniation, interbody fusion, infection, as well as dorsal medial branch rhizotomy. The goal of medial branch rhizotomy is to denervate lumbar facet joints that are contributing to axial back pain. The previous chapter focused on percutaneous techniques, while this chapter will describe endoscopic rhizotomy.

scholarly journals Bipolar Radiofrequency Neurotomy to Treat Neck and Back Pain in Patients with Automatic Implantable Cardioverter Defibrillator

2016 ◽  
Vol 3;19 (3;3) ◽  
pp. E505-E509 ◽  
Author(s):  
Alexander Bautista
Keyword(s):  
Back Pain ◽  
Pain Relief ◽  
Medial Branch ◽  
Facet Joints ◽  
Cardioverter Defibrillator ◽  
Radiofrequency Neurotomy ◽  
Bipolar Radiofrequency ◽  
Automatic Implantable Cardioverter Defibrillator ◽  
Lumbar Facet ◽  
Lumbar Facet Joints

We report 2 cases of successful treatment of neck and back pain with bipolar radiofrequency ablation (RFA) of the cervical and lumbar facet joints in patients with an automatic implantable cardioverter defibrillator (AICD). Two patients with complex cardiac histories and AICD devices were treated with bipolar RFA of the facet joints. One presented with axial neck pain and the other with axial back pain. The histories and physical examinations were consistent with facetogenic pain. Diagnostic medial branch block resulted in more than 70% pain relief lasting for several days, allowing patients to perform routine daily activities without significant pain. However, we were concerned about the use of conventional RFA of the medial branches of nerves for the fear of interference with the function of AICD by the RF currents and energy. We took advantage of the localized and limited current of bipolar RFA to perform this procedure for the cervical or lumbar facet joints avoiding any interference with the function of AICD. The procedures provided long-term pain relief to the patients, and marked improvement in their functional status without any evident complications related to the function of their AICD. This case report describes the safe and successful completion of bipolar RFA of the medial branch nerves to treat cervical and lumbar facetogenic pain in patients with AICD. This modality of treatment may be considered in patients with AICD. We are finding it to be increasingly common that patients who present with chronic neck and back pain have AICDs in place. Key words: Back pain, neck pain, facet, AICD, radiofrequency neurotomy, bipolar lesioning

scholarly journals Best practice in radiofrequency denervation of the lumbar facet joints: a consensus technique

2019 ◽  
Vol 14 (1) ◽  
pp. 47-56 ◽  
Author(s):  
Sam Eldabe ◽  
Anisah Tariq ◽  
Sherdil Nath ◽  
Ashish Gulve ◽  
Hugh Antrobus ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Best Practice ◽  
Controlled Trial ◽  
Medial Branch ◽  
Low Back ◽  
Facet Joints ◽  
Radiofrequency Denervation ◽  
Lumbar Facet ◽  
Lumbar Facet Joints

Background: Radiofrequency denervation is used to treat selected people with low back pain. Recent trials have been criticised for using a sub-optimal intervention technique. Objectives: To achieve consensus on a best practice technique for administering radiofrequency denervation of the lumbar facet joints to selected people with low back pain. Study design: A consensus of expert professionals in the area of radiofrequency denervation of the lumbar facet joints. Methods: We invited a clinical member from the 30 most active UK departments in radiofrequency pain procedures and two overseas clinicians with specific expertise to a 1 day consensus meeting. Drawing on the known anatomy of the medial branch, the theoretical basis of radiofrequency procedures, a survey of current practice and collective expertise, delegates were facilitated to reach consensus on the best practice technique. Results: The day was attended by 24 UK and international clinical experts. Attendees agreed a best practice technique for the conduct of radiofrequency denervation of the lumbar facet joints. Limitations: This consensus was based on a 1 day meeting of 24 clinical experts who attended and took part in the discussions. The agreed technique has not been subject to input from a wider community of experts. Conclusions: Current best practice for radiofrequency denervation has been agreed for use in a UK trial. Group members intend immediate implementation in their respective trusts. We propose using this in a planned Randomised Controlled Trial (RCT) of radiofrequency denervation for selected people with low back pain.

Sonoanatomic indices of lumbar facet joints in patients with facetogenic back pain in comparison to healthy subjects

2017 ◽  
Vol 36 ◽  
pp. 67-71 ◽  
Author(s):  
Poupak Rahimzadeh ◽  
Hamid Reza Faiz ◽  
Ali Reza Baghaee ◽  
Nader D. Nader
Keyword(s):  
Back Pain ◽  
Healthy Subjects ◽  
Facet Joints ◽  
Lumbar Facet ◽  
Lumbar Facet Joints

Medial Branch Blocks Versus Pericapsular Blocks in Selecting Patients for Percutaneous Cryodenervation of Lumbar Facet Joints

2007 ◽  
Vol 32 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Christof Birkenmaier ◽  
Andreas Veihelmann ◽  
Hans-Heinrich Trouillier ◽  
Jörg Hausdorf ◽  
Christoph von Schulze Pellengahr
Keyword(s):  
Medial Branch ◽  
Facet Joints ◽  
Lumbar Facet ◽  
Lumbar Facet Joints

Radiofrequency Denervation of Lumbar Facet Joints in the Treatment of Chronic Low Back Pain

2005 ◽  
Vol 21 (4) ◽  
pp. 335-344 ◽  
Author(s):  
Roelof M. A. W van Wijk ◽  
Jos W. M Geurts ◽  
Herman J Wynne ◽  
Edwin Hammink ◽  
Erik Buskens ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Facet Joints ◽  
Radiofrequency Denervation ◽  
Lumbar Facet ◽  
Lumbar Facet Joints

Use of Medial Branch Blocks Before Radiofrequency Ablation for Lumbar Facet Joints

PM&R ◽  
2012 ◽  
Vol 4 (7) ◽  
pp. 521-526
Author(s):  
Jonas M. Sokolof ◽  
Devi E. Nampiaparampil ◽  
Gary P. Chimes
Keyword(s):  
Radiofrequency Ablation ◽  
Medial Branch ◽  
Facet Joints ◽  
Lumbar Facet ◽  
Lumbar Facet Joints

Medial Branch Blocks Versus Pericapsular Blocks in Selecting Patients for Percutaneous Cryodenervation of Lumbar Facet Joints

2007 ◽  
Vol 32 (1) ◽  
pp. 27-33 ◽  
Author(s):  
C BIRKENMAIER ◽  
A VEIHELMANN ◽  
H TROUILLIER ◽  
J HAUSDORF ◽  
C VONSCHULZEPELLENGAHR
Keyword(s):  
Medial Branch ◽  
Facet Joints ◽  
Lumbar Facet ◽  
Lumbar Facet Joints

A New Sensor Array for Measuring Intra-Articular Pressure: Evaluation and Validation

2010 ◽  
Author(s):  
Judson B. Welcher ◽  
John M. Popovich ◽  
Wafa Tawackoli ◽  
Thomas P. Hedman
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Sensor Array ◽  
Low Back ◽  
Facet Joints ◽  
Anatomical Structures ◽  
Spine Motion ◽  
Lumbar Facet ◽  
Lumbar Facet Joints

Deficiencies The lumbar facet joints are the major load bearing elements in the lumbar spine posterior column and they are considered one of the anatomical structures that can cause low back pain. They also contribute to the amount and type of lumbar spine motion.

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