[Denervation of the posterior lumbar vertebral apophyses by thermocoagulation in chronic low back pain. Results of the treatment of 103 patients].
The facet syndrome seems to be a common cause of low back pain. Percutaneous radiofrequency lumbar facet denervation, developed by Shealy, may be of therapeutic value in facet syndrome patients. This method consists in thermocoagulation of the middle branch of the dorsal primary ramus of the spinal nerve. The authors report their experience with this technique in a retrospective series of 103 patients with chronic low back pain ascribed to facet syndrome. Results were evaluated after 6 and 24 months using a questionnaire and the Stauffer and Coventry classification. Among the 86 patients who completed the questionnaire, 38.4% considered the treatment successful, whereas 61.6% considered that it had not been of benefit. According to the Stauffer and Coventry classification, there were 20.9% excellent results, 22.1% fair results, and 57% failures. Results were better in those patients with a negative history for surgical discectomy. Success rates reported in the literature vary widely, from 14% to 76%. Interpretation of these data is difficult since studies used a broad range of treatment techniques, evaluation methods, and patient selection criteria. A prospective study using stringent inclusion criteria and appropriate evaluation criteria taking quality of life into account is needed to determine the role of percutaneous facet denervation among other treatment options available to low back pain patients.
Goupille
P
P
Service de Rhumatologie, CHU Trousseau, Tours.
Cotty
P
P
Fouquet
B
B
Alison
D
D
Laffont
J
J
Valat
J P
JP
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
Dénervation des apophyses articulaires postérieures lombaires par thermocoagulation dans les lombalgies chroniques. Résultats du traitement chez 103 patients.