Abstract
Background: Lumbar facet joints are a frequent source of pain in degenerative lumbar spine disease. In many cases, they may actually be the predominant source of pain.
Material & Methods: Our target criteria were low back pain (VAS 0 10), back pain related limitation in daily activities and general acceptance of the treatment method. Inclusion criteria: Deep-seated non-sciatic low back pain, failure of conservative measures, positive diagnostic medial branch blocks. Exclusion criteria: Previous spinal surgery, relevant spinal stenosis, activated osteochondrosis, radicular pain. Diagnostic blocks were performed under fluoroscopy, improvement in low back pain of more than 50% for more than 3 hours was considered a positive block. Cryodenervation was performed also under fluoroscopy at a separate appointment. Since June 2002, 52 patients (average age 56) were entered into the study. 2 Patients were lost to follow-up and 2 others had to be excluded, so that 48 patients were available for evaluation. At present, we have a 3-month follow-up for all 48 patients, a 6-month follow-up for 44 patients, a 12-month follow-up for 32 patients and an 18-month follow-up for 19 patients.
Results: 2 weeks after treatment, 65 % of patients reported significant improvement, 35 % reported little or no change in pain. The average VAS of the complete study group dropped from 7.7 preoperatively to 3.3 at two weeks and to 3.45 at three and eighteen months postoperatively (p < 0.05). Limitation in daily activities improved parallel to the reduction in low back pain and 33 out of 48 patients would have the procedure performed again while 2 remained undecided
Conclusion: Percutaneous medial branch cryodenervation is a safe and effective means for the treatment of lumbar facet joint pain.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
