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Facet radiofrequence

Min Cheol Chang, Yun-Woo Cho, Da Hyun Ahn, Kyung Hee Do
OBJECTIVE: Many treatment techniques have been used for refractory lumbar facet joint pain; however, their efficacy has been controversial. In this study, we investigated the clinical efficacy and safety of intraarticular pulsed radiofrequency for the treatment of refractory lumbar facet joint pain in patients with low back pain. METHODS: Twenty patients with refractory lumbar facet joint pain were recruited and each patient was treated using intraarticular pulsed radiofrequency...
January 6, 2018: World Neurosurgery
Laxmaiah Manchikanti, Vidyasagar Pampati, Alan D Kaye, Joshua A Hirsch
Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions...
2017: International Journal of Medical Sciences
Sayed E Wahezi, Edward Alexeev, John S Georgy, Nogah Haramati, Stephen A Erosa, Jay M Shah, Sherry Downie
BACKGROUND: Lumbar facet arthropathy is a common cause of low back pain. Literature supports treatment with radiofrequency ablation (RFA) of associated nerves that innervate lumbar facets when alternative conservative therapies have failed. Diagnostic local anesthetic blocks precede therapeutic ablation, but have a false-positive rate of 27%-63%, and some authors have questioned their utility in predicting therapeutic response to RFA. The authors of the current study believe that injectate volume may be a contributing factor to false positivity...
November 22, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Jessica Arias Garau
Facet or zygapophysial joint pain is commonly seen in the aging population. Interventional procedures, such as facet joint nerve blocks, facet intraarticular injections, and radiofrequency denervation, are used for the diagnosis and treatment of axial spinal chronic neck and low back pain. The focus of this article is to understand how radiofrequency denervation works in the cervical and lumbar spine and to be able to properly select appropriate patients who might benefit from this safe and effective procedure...
February 2018: Physical Medicine and Rehabilitation Clinics of North America
Munnan Al-Najjim, Rohit Shah, Mahmoud Rahuma, Omar Abdul Gabbar
The lumbar facet joints have been implicated as one of the causes of low-back pain syndromes. About 15-40% of patients who presented with chronic low-back pain was attributed to lumbar facet joint pain. The purpose of this study was to analyse whether radiofrequency denervation is better than SHAM procedure in treating chronic low-back pain caused by lumbar zygapophysial joints pathology. From the four identified randomised control trials, there is conflicting evidence at an intermediate 3-6-month stage, however; one study demonstrates statistical significance of radiofrequency denervation at 3 months...
March 2018: Journal of Orthopaedics
David A Provenzano, Asokumar Buvanendran, Oscar A de León-Casasola, Samer Narouze, Steven P Cohen
No abstract text is available yet for this article.
January 2018: Regional Anesthesia and Pain Medicine
Jae Chul Koh, Do Hyeong Kim, Youn Woo Lee, Jong Bum Choi, Dong Hun Ha, Ji Won An
Background: To achieve a prolonged therapeutic effect in patients with lumbar facet joint syndrome, radiofrequency medial branch neurotomy (RF-MB) is commonly performed. The purpose of this study was to evaluate the prognostic value of paravertebral muscle twitching when performing RF-MB in patients with lumbar facet joint syndrome. Methods: We collected and analyzed data from 68 patients with confirmed facet joint syndrome. Sensory stimulation was performed at 50 Hz with a 0...
October 2017: Korean Journal of Pain
Robert E Jacobson, Ovidiu Palea, Michelle Granville
Radiofrequency facet ablation (RFA) has been performed using the same technique for over 50 years. Except for variations in electrode size, tip shape, and change in radiofrequency (RF) stimulation parameters, using standard, pulsed, and cooled RF wavelengths, the target points have remained absolutely unchanged from the original work describing RFA for lumbar pain control. Degenerative changes in the facet joint and capsule are the primary location for the majority of lumbar segmental pathology and pain. Multiple studies show that the degenerated facet joint is richly innervated as a result of the inflammatory overgrowth of the synovium...
September 1, 2017: Curēus
Ji Woon Lim, Yun-Woo Cho, Dong Gyu Lee, Min Cheol Chang
BACKGROUND: Disorders of the facet joints are some of the most common sources of chronic spinal pain. Facet joint pain is responsible for approximately 50% of patients with chronic neck pain. Pulsed radiofrequency (PRF) stimulation, after placing needle electrodes into the joint space, has been recently reported for the management of joint pain. OBJECTIVE: The aim of this study was to evaluate the effect of intraarticular (IA) PRF for the management of cervical facet joint (CFJ) pain...
September 2017: Pain Physician
Doina Thomas, Klaus J Schnake
No abstract text is available yet for this article.
September 2017: European Spine Journal
Steven P Cohen, W Michael Hooten
Neck pain imposes a considerable personal and socioeconomic burden-it is one of the top five chronic pain conditions in terms of prevalence and years lost to disability-yet it receives a fraction of the research funding given to low back pain. Although most acute episodes resolve spontaneously, more than a third of affected people still have low grade symptoms or recurrences more than one year later, with genetics and psychosocial factors being risk factors for persistence. Nearly half of people with chronic neck pain have mixed neuropathic-nociceptive symptoms or predominantly neuropathic symptoms...
August 14, 2017: BMJ: British Medical Journal
Charles A Odonkor, Yian Chen, Peju Adekoya, Bryan J Marascalchi, Hira Chaudhry-Richter, Teresa Tang, Christopher Abruzzese, Berklee K Cohen, Steven P Cohen
BACKGROUND: Low back pain is the leading cause of years lost to disability with approximately 15%-25% of the chronic back pain population suffering from lumbar facet arthropathy. No large-scale study has sought to systematically identify inciting events for lumbar facet arthropathy. The aim of this study is to quantify the proportion of individuals with lumbar facetogenic pain who report a specific precipitating event(s) and to determine if there is a correlation between these events and treatment outcome...
July 10, 2017: Anesthesia and Analgesia
Jesse Hatgis, Michelle Granville, Aldo Berti, Robert E Jacobson
Lumbar facet cysts are frequently found in patients with facet degeneration and segmental instability. When the facet cyst is localized in the neural foramina and lateral recess or becomes large, it can cause radiculopathy or neurogenic claudication. These symptomatic cysts are typically treated interventionally with drainage and a corticosteroid injection or attempts via overinflation to rupture the cyst; however, these procedures have a significant recurrence rate (up to 50%) and often need to be repeated or lead to lumbar surgery if unsuccessful...
June 6, 2017: Curēus
Johan N S Juch, Esther T Maas, Raymond W J G Ostelo, J George Groeneweg, Jan-Willem Kallewaard, Bart W Koes, Arianne P Verhagen, Johanna M van Dongen, Frank J P M Huygen, Maurits W van Tulder
Importance: Radiofrequency denervation is a commonly used treatment for chronic low back pain, but high-quality evidence for its effectiveness is lacking. Objective: To evaluate the effectiveness of radiofrequency denervation added to a standardized exercise program for patients with chronic low back pain. Design, Setting, and Participants: Three pragmatic multicenter, nonblinded randomized clinical trials on the effectiveness of minimal interventional treatments for participants with chronic low back pain (Mint study) were conducted in 16 multidisciplinary pain clinics in the Netherlands...
July 4, 2017: JAMA: the Journal of the American Medical Association
Dong Gyu Lee, Sang Ho Ahn, Yun Woo Cho, Kyung Hee Do, Sang Gyu Kwak, Min Cheol Chang
STUDY DESIGN: A prospective observational study. OBJECTIVE: The aim of this study was to show the effect of intra-articular (IA) thoracic facet joint (TFJ) steroid injection for the management of TFJ pain, and to compare it with the effect of therapeutic thoracic medial branch block (MBB) with a local anesthetic and steroid. SUMMARY OF BACKGROUND DATA: Several studies have shown the effects of thoracic MBB with local anesthetics with or without steroids and radiofrequency neurotomy in managing TFJ pain, but thus far, the effectiveness of IA TFJ steroid injection has not been studied...
January 15, 2018: Spine
Chang-Hyun Lee, Chun Kee Chung, Chi Heon Kim
BACKGROUND CONTEXT: Radiofrequency denervation is commonly used for the treatment of chronic facet joint pain that has been refractory to more conservative treatments, although the evidence supporting this treatment has been controversial. PURPOSE: We aimed to elucidate the precise effects of radiofrequency denervation in patients with low back pain originating from the facet joints relative to those obtained using control treatments, with particular attention to consistency in the denervation protocol...
May 30, 2017: Spine Journal: Official Journal of the North American Spine Society
Robert E Jacobson, Michelle Granville, Jesse Hatgis DO
INTRODUCTION: By using a combination of magnetic resonance imaging (MRI) and computed tomography (CT) of the lumbar spine, it is possible to distinguish between spinal stenosis caused by bone compression and specific soft tissue epidural intraspinal lesions that cause localized spinal canal stenosis and neural compression. Examples include facet cysts and yellow ligament hypertrophy. Many of these patients are elderly with medical comorbidities that make open surgery problematic. MATERIALS & METHODS: This is a study of patients with predominantly soft tissue stenosis being treated with targeted intraspinal radiofrequency (RF) heat ablation...
March 10, 2017: Curēus
Jesse Hatgis, Michelle Granville, Robert E Jacobson
INTRODUCTION: A small subset of patients who underwent successful vertebral compression fracture (VCF) augmentation procedures may develop subsequent pain requiring spinal injections. In a retrospective analysis, we determined whether the pain was related to the original fracture site or to another area within the lumbar or thoracic spine. The pain occurred either at the same/adjacent level and/or non-adjacent level as the VCF. Interventional treatments primarily targeted the facet joints, specifically in the form of facet joint blocks and/or radiofrequency ablation to the medial branches...
February 28, 2017: Curēus
Kyung Hee Do, Sang Ho Ahn, Yun Woo Cho, Min Cheol Chang
BACKGROUND: This study aimed to demonstrate the effect of intra-articular (IA) lumbar facet joint (LFJ) pulsed radiofrequency (PRF) for the management of LFJ pain, and to compare the effect of IA LFJ PRF to IA corticosteroid injection (ICI). Pathology in the LFJ is a common source of lower back pain (LBP). It is responsible for chronic LBP in approximately 15% to 45% of patients. It has been reported that PRF stimulation can effectively reduce refractory joint pain. METHODS: Sixty patients with LFJ pain were recruited and randomly assigned to 1 of 2 groups: the IA PRF group and the ICI group...
March 2017: Medicine (Baltimore)
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting: Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective: To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
July 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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