Alternative denervation using laser irradiation in lumbar facet syndrome.
OBJECTIVE
Facet syndrome is persistent low back pain that might be treated with some surgical interventions. The target of surgical techniques is the transverse process bases where the medial nerve branches innervated the facet. However, highly variable success rates have been demonstrated in different series.


METHODS
We carried out laser denervation to the dorsal surface of the facet capsule, where it is richly innervated with medial nerve branches.


RESULTS
One year after laser denervation, 17 patients (81%) experienced complete or greater than 70% pain reduction in all 21 patients. Among the six patients who had previously undergone spinal surgery, two (33.3%) experienced successful pain relief. Overall, in four patients (19%), the response to laser denervation at 1-year follow-ups was not successful.


CONCLUSIONS
The dorsal surface of the facet capsule might be a more preferable target for facet denervation.
Iwatsuki
Koichi
K
Department of Neurosurgery, Osaka University Medical School, Suita, Osaka, Japan. kiwatsuki@nsurg.med.osaka-u.ac.jp
Yoshimine
Toshiki
T
Awazu
Kunio
K
D000328:Adult; D000368:Aged; D003714:Denervation / Q000379:methods*; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000294:innervation / Q000601:surgery*; D053685:Laser Therapy; D017116:Low Back Pain / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000294:innervation; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D019051:Rhizotomy / Q000379:methods*; D013577:Syndrome; D021801:Zygapophyseal Joint / Q000294:innervation / Q000601:surgery*