title: Radiofrequency treatment of facet-related pain: evidence and controversies.
abstract: Pain originating from the lumbar facet joints is estimated to represent about 15% of all low back pain complaints. The diagnostic block is considered to be a valuable tool for confirming facetogenic pain. It was demonstrated that a block of the ramus medialis of the ramus dorsalis is preferred over an intra-articular injection. The outcome of the consequent radiofrequency treatment is not different in patients reporting over 80% pain relief after the diagnostic block than in those who have between 50% and 79% pain relief. There is one well-conducted comparative trial assessing the value of one or two controlled diagnostic blocks to none. The results of the seven randomized trials on the use of radiofrequency treatment of facet joint pain demonstrate that good patient selection is imperative for good clinical outcome. Therefore, we suggest one block of the ramus medialis of the ramus dorsalis before radiofrequency treatment.
authors.affiliation: Department of Anesthesiology and Multidisciplinary Pain Centre, Ziekenhuis Oost-Limburg, Campus André Dumont, Stalenstraat 2, 3600 Genk, Belgium. Jan.VanZundert@zol.be
authors.forename: Jan
authors.initials: J
authors.lastname: Van Zundert
authors.forename: Pascal
authors.initials: P
authors.lastname: Vanelderen
authors.forename: Alfons
authors.initials: A
authors.lastname: Kessels
authors.forename: Maarten
authors.initials: M
authors.lastname: van Kleef
mesh_terms: D017115:Catheter Ablation / Q000379:methods; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods*; D017116:Low Back Pain / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D009407:Nerve Block / Q000379:methods*; D017060:Patient Satisfaction; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods*; D011788:Quality of Life; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000187:drug effects / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*
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