title: Cryoneurolysis for zygapophyseal joint pain: a retrospective analysis of 117 interventions.
abstract: OBJECTIVE
  Lumbar facet joint syndrome (LFJS) is the cause of pain in 15-54% of the patients with low-back pain. There are few studies of cryotherapy for LFJS, focusing mainly on pain scores rather than further outcome measures. The aim of the study was to determine the long-term outcome after cryoneurolysis of lumbar facet joints, looking at pain scores, pain-related impairment patient satisfaction, and pain-related anxiety/depression.
  
  
  METHODS
  The study design was a retrospective observational study. In a 4-year period, 117 cryoneurolyses were performed in 91 patients under CT guidance in the prone position. Data from patient charts and questionnaires pre- and post-treatment were evaluated.
  
  
  RESULTS
  The mean pain rating sank from 7.70 before treatment to 3.72 post treatment. In the post-interventional 3 months follow-up, this value rose to 4.22. At follow-up (mean 1.7 years, range 6-52 months), the mean visual analogue scale (VAS) was 4.99. The pain disability index revealed statistically significant improvements in the following items: familiar and domestic duties, recreation, social activities, profession and vitally indispensable activities (p < 0.05). Hospital anxiety and depression scale (HADS) scores for depression showed a statistically significant decline after therapy, whereas scores for anxiety did not. A subgroup of patients who did not benefit from cryoneurolysis had elevated depression scores.
  
  
  CONCLUSIONS
  Cryoneurolysis for LFJS can lead to favourable results with sustained pain relief, amelioration of pain-related disability and reduction of depression scores.
authors.affiliation: Interdisciplinary Pain Centre, Breisacherstr. 64, 79106, Freiburg, Germany. tilman.wolter@uniklinik-freiburg.de
authors.forename: Tilman
authors.initials: T
authors.lastname: Wolter
authors.forename: M
authors.initials: M
authors.lastname: Deininger
authors.forename: U
authors.initials: U
authors.lastname: Hubbe
authors.forename: M
authors.initials: M
authors.lastname: Mohadjer
authors.forename: S
authors.initials: S
authors.lastname: Knoeller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D003452:Cryosurgery / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D021801:Zygapophyseal Joint / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*