title: Radiofrequency Neurolysis for Lumbar Pain Using a Variation of the Original Technique.
abstract: BACKGROUND
  Zygapophysial joint arthrosis is a pathology related with axial lumbar pain. The most accepted treatment, after failure of medical management, is the thermal denervation of the medial branch. Nonetheless, the placement of the heat probe remains a challenge to surgeons, even when using the fluoroscope. Using a variation of Shealy's and Bogduk's original techniques, which includes ablation of the medial branch and the nerves present in the joint capsule, we hypothesize that we can obtain similar outcomes to those found in the literature.
  
  
  OBJECTIVE
  To present the results attained over the last 8 years in the treatment of axial lumbar pain from zygapophysial joints degeneration, by employing a variation of the lumbar medial branch neurotomy technique, called 360-degree facet rhizotomy with radiofrequency.
  
  
  METHODS
  Retrospective evaluation.
  
  
  METHODS
  Spine Center - Minimally Invasive Surgery in Bogotá, Colombia.
  
  
  METHODS
  A medical chart review was conducted for patients diagnosed with axial lumbar pain from zygapophysial joint arthrosis and treated with 360-degree facet rhizolysis with a high frequency radiofrequency energy source between 2008 and 2014. Data were evaluated under modified MacNab and pre- and postoperative visual analog scale (VAS) criteria.
  
  
  RESULTS
  We obtained a total of 73 patients. The average population age was 58.6 years. The preoperative VAS obtained was 7.3, which changed to 1.7 one year after the procedure. The MacNab criteria 12 months after the surgery gave satisfactory outcomes (excellent and good) from 91.7% of the patients.
  
  
  CONCLUSIONS
  This retrospective study includes inherent limitations and only offers one year follow-up data.
  
  
  CONCLUSIONS
  Thermal therapy for zygapophysial joint arthrosis constitutes a safe and effective technique. The one year follow-up data presented here show that the ablation of the medial branch and nerves present in the joint capsule leads to satisfactory results in a high percentage of patients.
authors.affiliation: Research Team from Centro de Columna, Bogotá, Colombia.
authors.forename: Jorge F Ramirez
authors.initials: JF
authors.lastname: Leon
authors.affiliation: Research Team from Centro de Columna, Bogotá, Colombia.
authors.forename: Jose G Rugeles
authors.initials: JG
authors.lastname: Ortiz
authors.affiliation: Research Team from Centro de Columna, Bogotá, Colombia.
authors.forename: Enrique Osorio
authors.initials: EO
authors.lastname: Fonseca
authors.affiliation: Research Team from Centro de Columna, Bogotá, Colombia.
authors.forename: Carolina Ramirez
authors.initials: CR
authors.lastname: Martinez
authors.affiliation: Research Team from Centro de Columna, Bogotá, Colombia.
authors.forename: Gabriel Oswaldo Alonso
authors.initials: GO
authors.lastname: Cuellar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D003714:Denervation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D012189:Retrospective Studies; D021801:Zygapophyseal Joint / Q000473:pathology / Q000601:surgery*