title: Radiofrequency neurotomy for treatment of low back pain in patients with minor degenerative spondylolisthesis.
abstract: BACKGROUND
  Degenerative spondylolisthesis is one of the major causes for low back pain. Morphological abnormalities of the zygapophysial joints are a predisposing factor in the development of degenerative spondylolisthesis. Therefore, radiofrequency neurotomy seems to be a rational therapy.
  
  
  OBJECTIVE
  To determine if radiofrequency neurotomy is effective for patients with low back pain and degenerative spondylolisthesis.
  
  
  METHODS
  Retrospective practice audit.
  
  
  METHODS
  Single spine center
  
  
  METHODS
  Charts of all patients with degenerative spondylolisthesis who underwent treatment with radiofrequency neurotomy during a time period of 3 years were reviewed. Only patients with magnetic resonance imaging confirming the diagnosis were included. Patients with a lumbar spine operation in their history, patients with neurological deficits, and patients with a follow-up less than 3 months were excluded. Patients were treated with lumbar radiofrequency neurotomy. Positive treatment response was defined as at least a 50% reduction in pain. A radiofrequency neurotomy was only performed after positive diagnostic medial branch blocks.
  
  
  RESULTS
  During a time period of 3 years, 1,490 patients were treated with lumbar radiofrequency neurotomy. Forty of these patients with degenerative spondylolisthesis were included. A significant pain reduction was achieved in 65 % of the patients.
  
  
  CONCLUSIONS
  This audit is retrospective and observational, and therefore does not represent a high level of evidence. However, to our knowledge, since this information has not been previously reported and no specific nonoperative treatment for lumbar pain in patients with degenerative spondylolisthesis exists, it appears to be the best available research upon which to recommend treatment and to plan higher quality studies.
  
  
  CONCLUSIONS
  Zygapophysial joints are a possible source of pain in patients with spondylolisthesis. Radiofrequency neurotomy is a rational, specific nonoperative therapy in addition to other nonoperative therapy methods with a success rate of 65%. This is the first study to determine the effect of radiofrequency neurotomy in patients with minor degenerative spondylolisthesis.
authors.affiliation: Nova Clinic, Biberach, Baden-Württemberg, Germany. klessinger@nova-clinic.de
authors.forename: Stephan
authors.initials: S
authors.lastname: Klessinger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010147:Pain Measurement; D000078702:Radiofrequency Therapy; D012189:Retrospective Studies; D013168:Spondylolisthesis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000473:pathology / Q000601:surgery*