Radiofrequency facet joint neurotomy in treatment of facet syndrome.
METHODS
Retrospective analyses of 50 patients with lumbar facet syndrome treated with lumbar facet joint neurotomy.


OBJECTIVE
To establish the efficacy of lumbar facet joint neurotomy under optimum conditions in selected patients.


BACKGROUND
With the realization of the significance of facet joints in the etiology of chronic low back pain over the last decade, many studies were conducted about various methods of treating the facet joint syndrome.


METHODS
Fifty patients with lumbar facet syndrome with at least 80% pain relief by controlled, diagnostic medial branch blocks underwent lumbar facet joint neurotomy. Before surgery, all were examined carefully both clinically and radiologically and evaluated by visual analog scale (VAS) and descriptive system of health-related quality of life state (EQ5D) measures of pain, disability, and treatment satisfaction. All outcome measures were repeated postoperatively and at 12 months after surgery.


RESULTS
Of the 50 patients 35 were females and 15 were males with a mean age of 51.82±16.99 years. One level was treated in 26 patients, 2 levels in 14, 3 levels in 8, and 4 levels were treated in 2 patients. Symptom duration was ranging between 2 and 24 months with a mean of 7.64±5.98 months. Mean preoperative, postoperative, and at the 12th month VAS were 75.2±11.29, 23.8±10.28, and 24.6±11.817, respectively.Forty-eight percent of patients obtained a relative reduction of at least 70% in VAS, and 86% obtained a reduction of at least 60% at the 12th month. Health-related quality of life state was improved in all patients. When the VAS scores were evaluated with respect to the ages of patients, level numbers, and preoperative symptom duration, no significant differences were found, [0.106, 0.635 and 0.526 (preoperative VAS); 0.033, 0.555, and 0.235 (postoperative VAS); 0.701, 0.978, and 0.155 (follow-up VAS), respectively].


CONCLUSIONS
The most important factors determining success of this procedure is strict patient selection criteria and technique of the procedure.
Yilmaz
Cem
C
Department of Neurosurgery, Baskent University, Istanbul Hospital, Istanbul, Turkey.
Kabatas
Serdar
S
Cansever
Tufan
T
Gulsen
Salih
S
Coven
Ilker
I
Caner
Hakan
H
Altinors
Nur
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001175:Arthrography; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D012189:Retrospective Studies; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000601:surgery*