Articular facets syndrome: diagnostic grading and treatment options.
Approximately 80% of the adult population suffers from chronic lumbar pain with episodes of acute back pain. The aetiology of this disorder can be very extensive: degenerative scoliosis, spondiloarthritis, disc hernia, spondylolysis, spondylolisthesis and, in the most serious cases, neoplastic or infectious diseases. For several years, the attention of surgeons was focused on the articular facets syndrome (Lilius et al. in J Bone Joint Surg (Br) 71-B:681-684, 1998), characterised clinically by back pain and selective pressure soreness at the level of the facets involved. The instrumental framework highlights widespread zigoapophysary arthritis and hypertrophy/degeneration of articular facets due to a functional overload. This retrospective study analyses the patients who arrived at our observation and were treated with a neuroablation using a pulsed radiofrequency procedure, after a CT-guided infiltration test with anaesthetic and cortisone. From the data collected, it would seem that this procedure allows a satisfactory remission of the clinical symptoms, leaving the patient free from pain; furthermore, this method can be repeated in time.
U.O. Scoliosis and Vertebral Disease, Orthopedic Institute G. Pini, Piazza Cardinal Ferrari, 1, Milan 20122, Italy. misaggi@gpini.it
B
B
Misaggi
M
M
Gallazzi
M
M
Colombo
M
M
Ferraro
D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage; D017115:Catheter Ablation / Q000379:methods* / Q000706:statistics & numerical data; D003348:Cortisone / Q000008:administration & dosage; D003714:Denervation / Q000379:methods; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D010147:Pain Measurement / Q000379:methods*; D018579:Patient Selection; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D025241:Spondylarthritis / Q000150:complications; D013577:Syndrome; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D016474:Weight-Bearing / Q000502:physiology; D021801:Zygapophyseal Joint / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*
D000779:Anesthetics, Local; D003348:Cortisone