Development and Description of a New Multifidus‐Sparing Radiofrequency Neurotomy Technique for Facet Joint Pain

Pain Practice ◽  
2021 ◽  
Author(s):  
Marc A Russo ◽  
Danielle M Santarelli
Keyword(s):  
Joint Pain ◽  
Facet Joint ◽  
Radiofrequency Neurotomy ◽  
Facet Joint Pain

scholarly journals Systematic Review of Diagnostic Utility and Therapeutic Effectiveness of Thoracic Facet Joint Interventions

2008 ◽  
Vol 5;11 (10;5) ◽  
pp. 611-629
Author(s):  
Sairam Atluri
Keyword(s):  
Back Pain ◽  
Local Anesthetic ◽  
Joint Pain ◽  
Facet Joint ◽  
Therapeutic Interventions ◽  
Medial Branch ◽  
Radiofrequency Neurotomy ◽  
Level I ◽  
Facet Joint Pain ◽  
Facet Joint Interventions

Background: Chronic mid back and upper back pain caused by thoracic facet joints has been reported in 34% to 48% of the patients based on the responses to controlled diagnostic blocks. Systematic reviews have established moderate evidence for controlled comparative local anesthetic blocks of thoracic facet joints in the diagnosis of mid back and upper back pain, moderate evidence for therapeutic thoracic medial branch blocks, and limited evidence for radiofrequency neurotomy of therapeutic facet joint nerves. Objectives: To determine the clinical utility of diagnostic and therapeutic thoracic facet joint interventions in diagnosing and managing chronic upper back and mid back pain. Study Design: Systematic review of diagnostic and therapeutic thoracic facet joint interventions. Methods: Review of the literature for utility of facet joint interventions in diagnosing and managing facet joint pain was performed according to the Agency for Healthcare Research and Quality (AHRQ) criteria for diagnostic studies and observational studies and the Cochrane Musculoskeletal Review Group criteria as utilized for interventional techniques for randomized trials. The level of evidence was classified as Level I, II, or III based on the quality of evidence developed by United States Preventive Services Task Force (USPSTF) for therapeutic interventions. Recommendations were based on the criteria developed by Guyatt et al. Data sources included relevant literature of the English language identified through searches of Medline and EMBASE from 1966 to July 2008 and manual searches of bibliographies of known primary and review articles. Results of the analysis were performed for diagnostic and therapeutic interventions separately. Outcome Measures: For diagnostic interventions, studies must have been performed utilizing controlled local anesthetic blocks. For therapeutic interventions, the primary outcome measure was pain relief (short-term relief = up to 6 months and long-term relief > 6 months) with secondary outcome measures of improvement in functional status, psychological status, return to work, and reduction in opioid intake. Results: Based on the controlled comparative local anesthetic blocks, the evidence for the diagnosis of thoracic facet joint pain is Level I or II-1. The evidence for therapeutic thoracic medial branch blocks is Level I or II-1. The recommendation is IA or 1B/strong for diagnostic and therapeutic medial branch blocks. Conclusion: The evidence for the diagnosis of thoracic facet joint pain with controlled comparative local anesthetic blocks is Level I or II-1. The evidence for therapeutic facet joint interventions is Level I or II-1 for medial branch blocks. Recommendation is 1A or 1B/strong for diagnostic and therapeutic medial branch blocks. Key words: Chronic thoracic pain, mid back or upper back pain, thoracic facet or zygapophysial joint pain, facet joint nerve blocks, medial branch blocks, controlled comparative local anesthetic blocks, therapeutic thoracic medial branch blocks, thoracic radiofrequency neurotomy, thoracic intraarticular facet joint injections

P11. Effectiveness of Repeated Radiofrequency Neurotomy for Cervical Facet Joint Pain

2007 ◽  
Vol 7 (5) ◽  
pp. 87S-88S
Author(s):  
Daniel Husted ◽  
Derek Orton ◽  
Jerome Schofferman ◽  
Garrett Kine
Keyword(s):  
Joint Pain ◽  
Facet Joint ◽  
Radiofrequency Neurotomy ◽  
Facet Joint Pain ◽  
Cervical Facet ◽  
Cervical Facet Joint

scholarly journals Systematic Review of Diagnostic Utility and Therapeutic Effectiveness of Cervical Facet Joint Interventions

2009 ◽  
Vol 2;12 (2;3) ◽  
pp. 323-344 ◽  
Author(s):  
Frank Falco
Keyword(s):  
Local Anesthetic ◽  
Joint Pain ◽  
Facet Joint ◽  
Medial Branch ◽  
Radiofrequency Neurotomy ◽  
Level Ii ◽  
Facet Joint Pain ◽  
Facet Joint Interventions ◽  
Cervical Facet ◽  
Cervical Facet Joint

Background: Chronic, recurrent neck pain is common and is associated with high pain intensity and disability, which is seen in 14% of the adult general population. Controlled studies have supported the existence of cervical facet or zygapophysial joint pain in 36% to 67% of these patients. However, these studies also have shown false-positive results in 27% to 63% of the patients with a single diagnostic block. There is also a paucity of literature investigating therapeutic interventions of cervical facet joint pain. Study Design: A systematic review of cervical facet joint interventions. Objective: To evaluate the accuracy of diagnostic facet joint nerve blocks and the effectiveness of cervical facet joint interventions. Methods: Medical databases and journals were searched to locate all relevant literature from 1966 through December 2008 in the English language. A review of the literature of the utility of facet joint interventions in diagnosing and managing facet joint pain was performed according to the Agency for Healthcare Research and Quality (AHRQ) criteria for diagnostic studies and observational studies and the Cochrane Musculoskeletal Review Group criteria as utilized for interventional techniques for randomized trials. Level of Evidence: The level of evidence was defined as Level I, II, or III based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Outcome Measures: For diagnostic interventions, studies must have been performed utilizing controlled local anesthetic blocks which achieve at minimum 80% relief of pain and the ability to perform previously painful movements. For therapeutic interventions, the primary outcome measure was pain relief (short-term relief up to 6 months and long-term relief greater than 6 months) with secondary outcome measures of improvement in functional status, psychological status, return to work, and reduction in opioid intake. Results: Based on the utilization of controlled comparative local anesthetic blocks, the evidence for the diagnosis of cervical facet joint pain is Level I or II-1. The indicated evidence for therapeutic cervical medial branch blocks is Level II-1. The indicated evidence for radiofrequency neurotomy in the cervical spine is Level II-1 or II-2, whereas the evidence is lacking for intraarticular injections. Limitations: A systematic review of cervical facet joint interventions is hindered by the paucity of published literature and lack of literature for intraarticular cervical facet joint injections. Conclusions: The evidence for diagnosis of cervical facet joint pain with controlled comparative local anesthetic blocks is Level I or II-1. The indicated evidence for therapeutic facet joint interventions is Level II-1 for medial branch blocks, and Level II-1 or II-2 for radiofrequency neurotomy. Key words: Chronic neck pain, cervical facet or zygapophysial joint pain, cervical medial branch blocks, controlled comparative local anesthetic blocks, cervical radiofrequency neurotomy, cervical intraarticular facet joint injections

Effectiveness of Repeated Radiofrequency Neurotomy for Cervical Facet Joint Pain

2008 ◽  
Vol 21 (6) ◽  
pp. 406-408 ◽  
Author(s):  
Daniel S. Husted ◽  
Derek Orton ◽  
Jerome Schofferman ◽  
Garrett Kine
Keyword(s):  
Joint Pain ◽  
Facet Joint ◽  
Radiofrequency Neurotomy ◽  
Facet Joint Pain ◽  
Cervical Facet ◽  
Cervical Facet Joint

scholarly journals Radiofrequency Neurotomy for Facet Joint Pain in Patients with Permanent Pacemakers and Defibrillators

Pain Medicine ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 411-412
Author(s):  
Clark Smith ◽  
Fred DeFrancesch ◽  
Jaymin Patel ◽  
Keyword(s):  
Joint Pain ◽  
Facet Joint ◽  
Radiofrequency Neurotomy ◽  
Facet Joint Pain

Comparison of Intra-articular Thoracic Facet Joint Steroid Injection and Thoracic Medial Branch Block for the Management of Thoracic Facet Joint Pain

Spine ◽  
2018 ◽  
Vol 43 (2) ◽  
pp. 76-80 ◽  
Author(s):  
Dong Gyu Lee ◽  
Sang Ho Ahn ◽  
Yun Woo Cho ◽  
Kyung Hee Do ◽  
Sang Gyu Kwak ◽  
...  
Keyword(s):  
Joint Pain ◽  
Facet Joint ◽  
Steroid Injection ◽  
Medial Branch ◽  
Medial Branch Block ◽  
Facet Joint Pain

The response to radiofrequency neurotomy of medial branches including a bipolar system for thoracic facet joints

2018 ◽  
Vol 18 (4) ◽  
pp. 747-753
Author(s):  
Olav Rohof ◽  
Chee Kean Chen
Keyword(s):  
Joint Pain ◽  
Rating Scale ◽  
Facet Joint ◽  
Controlled Trial ◽  
Case Series ◽  
Interventional Treatment ◽  
Medial Branch ◽  
Pain Disability Index ◽  
The Mean ◽  
Facet Joint Pain

AbstractBackground and aimsThe evidence for interventional treatment of thoracic facet joint pain remains limited. This is partly due to inconsistency of the path of thoracic medial branches and a lower incidence of thoracic facet pain among spine pain patients. The purpose of this study is to evaluate the efficacy of bipolar radiofrequency (RF) neurotomy of medial branches for treating chronic thoracic facet joint pain.MethodsThis is a retrospective record review of all patients diagnosed to have thoracic facet pain with diagnostic block and subsequently treated with bipolar RF neurotomy of medial branch between January 2012 and December 2015. The outcome measures were mean changes in Numeral Rating Scale (NRS) and Pain Disability Index (PDI).ResultsThere were 71 patients with complete data available for analysis. The mean age of the patients was 57.9±11.2 years. The mean duration of pain was 23±10.5 months. The majority of patients (82%) had pain reduction of more than 50% at 12 months after bipolar RF neurotomy. The NRS decreased significantly from baseline of 7.75±1.25 to 2.86±1.53 at 3 months and 2.82±1.29 at 12 months post-procedure (p<0.001.p<0.001, respectively). The PDI improved significantly from 40.92±12.22 to 24.15±9.79,p<0.05). There were no serious adverse effects or complications of the procedure reported in this study.ConclusionsBipolar RF neurotomy of thoracic medial branch is associated with a significant reduction in thoracic facet joint pain. The promising findings from this case series merit further assessment with prospective, randomized controlled trial which will produce a more reliable and accurate finding for its clinical applications.

Lumbar Facet–Mediated Pain

2016 ◽  
Author(s):  
Vikram B Patel
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lower Back Pain ◽  
Joint Pain ◽  
Facet Joint ◽  
Low Back ◽  
Lower Back ◽  
Facet Joint Pain ◽  
And Function ◽  
Lumbar Facet

Lumbar or lower back pain is a very debilitating condition that affects  almost one fifth of the adult population during a given year. Almost everyone walking on two feet is bound to suffer from some back pain during their lifetime. The health care burden for treating low back pain is enormous, especially if the lost work hours are combined with the amount used in diagnosing and treating low back pain. Lumbar facet (zygapophysial) joints are one of the major components involved in causing lower back pain. Diagnosing the pain generator is more of an art than a science. Combining various parameters in the patient’s history, physical examination, and diagnostic studies is not much different from solving a murder mystery. Although facet joint pain may be accompanied by other pain generators, that is, lumbar intervertebral disks, nerve roots, and vertebral bodies, once treated, the relief in pain is more helpful in performing proper rehabilitation and improving further deterioration in low back pain. Muscles are almost always painful due to myofascial pain syndrome that accompanies the facet joint–related pain. Treating one without addressing the other leads to failure in management and optimization of patient’s pain and function. Several treatments are available for treatment of facet joint–mediated pain, including steroid injections using a miniscule amount and radiofrequency ablation of the nerves supplying the facet joints (medial branches of the dorsal primary ramus of the lumbar nerve root). With proper diagnosis and treatment, a patient’s pain and function can be optimized to a level where it may not impact the day-to-day activities or even resumption of the patient’s routine job function. The following review describes the anatomy, pathophysiology, diagnosis, and treatment of lumbar facet joint–mediated pain.   Key words: facet joint pain, facet joint syndrome, low back pain, medial branch radiofrequency, spondylolisthesis

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