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Facet radiofrequence

Maarten van Eerd, Arno Lataster, Micha Sommer, Jacob Patijn, Maarten van Kleef
The cervical facet joints, also called the zygapophyseal joints, are a potential source of neck pain (cervical facet joint pain). The cervical facet joints are innervated by the cervical medial branches (CMBs) of the cervical segmental nerves. Cervical facet joint pain has been shown to respond to multisegmental radiofrequency denervation of the cervical medial branches. This procedure is performed under fluoroscopic guidance. Currently, three approaches are described and used. Those three techniques of radiofrequency treatment of the CMBs, classified on the base of the needle trajectory toward the anatomical planes, are as follows: the posterolateral technique, the posterior technique, and the lateral technique...
October 13, 2016: Pain Practice: the Official Journal of World Institute of Pain
David Arsanious, Emmanuel Gage, Jonathon Koning, Mazin Sarhan, Gassan Chaiban, Mohammed Almualim, Joseph Atallah
BACKGROUND: One of the potential side effects with radiofrequency ablation (RFA) includes painful cutaneous dysesthesias and increased pain due to neuritis or neurogenic inflammation. This pain may require the prescription of opioids or non-opioid analgesics to control post-procedural pain and discomfort. OBJECTIVES: The goal of this study is to compare post-procedural pain scores and post-procedural oral analgesic use in patients receiving continuous thermal radiofrequency ablation versus patients receiving pulsed dose radiofrequency immediately followed by continuous thermal radiofrequency ablation for zygopophaseal joint disease...
September 2016: Pain Physician
Wael Mohamed Mohamed Moussa, Wael Khedr
OBJECTIVES: Percutaneous radiofrequency denervation of the medial dorsal branch is often used in chronic low back pain of intervertebral facet etiology, which is sometimes difficult to perform and recurrence of pain often ensues. We theorized that shifting the target of RF coagulation to the facet joint capsule would provide an easier target and a longer-lived pain relieving response. PATIENTS AND METHODS: A prospective randomized controlled trial where 120 patients diagnosed with CLBP of a confirmed facet origin were randomly divided into three equal groups, the first was submitted to percutaneous radiofrequency coagulation of the facet joint capsule, the second underwent percuataneous denervation of the medial dorsal branch and the third did not receive radiofrequency lesioning...
November 2016: Clinical Neurology and Neurosurgery
Michele Curatolo
Synopsis Whiplash-associated disorder (WAD) is a group of symptoms and clinical manifestations resulting from rear-end or side impact. Despite the wide use of medications in WAD, the published research does not allow recommendations based on high evidence level. It may be meaningful to use nonsteroidal anti-inflammatory drugs in the acute posttraumatic phase. In chronic WAD, the use of nonsteroidal anti-inflammatory drugs is more concerning due to potential gastrointestinal and renal complications with prolonged use and lack of evidence for long-term benefits...
October 2016: Journal of Orthopaedic and Sports Physical Therapy
Joseph Solberg, David Copenhaver, Scott M Fishman
PURPOSE OF REVIEW: This review offers a critical examination of the biomechanical model that posits the posterior elements as a substantial contributor to pain in vertebral fracture. Further, the review assesses the treatment of posterior-element-associated pain in the setting of vertebral compression fracture in relation to vertebral augmentation. RECENT FINDINGS: In 2015, the only prospective randomized trial comparing percutaneous vertebroplasty with facet blockade was published in which authors found that percutaneous vertebroplasty produced better pain relief and function based on Oswestry Disability Index, Roland Morris Disability Questionnaire, and visual analog scale in the short term (≤1 week)...
October 2016: Current Opinion in Anaesthesiology
Laurence Perrin Barelli, Nadia Guzman Dettori
Low back pain (LBP) is a major medical and economical problem, because of its high incidence. Indeed, 70-85% of adult people will suffer from this kind of pain once in their life. We will focus in this article on chronic LBP, which represent an annual prevalence of 30% and more specifically on mechanical pain, with our without radiation into the legs. In case of failure of traditional analgesia combining drugs and physical therapies, we can propose interventional pain relief. This involves a series of diagnostic blocks (medial branch blocks), followed by the treatment (radiofrequency ablation)...
June 22, 2016: Revue Médicale Suisse
Elena A Kaye, Sebastien Monette, Govindarajan Srimathveeravalli, Majid Maybody, Stephen B Solomon, Amitabh Gulati
PURPOSE: About 10-40% of chronic low back pain cases involve facet joints, which are commonly treated with lumbar medial branch (MB) radiofrequency neurotomy. Magnetic resonance imaging-guided focused ultrasound (MRgFUS), a non-invasive, non-ionising ablation modality used to treat tumours, neuropathic pain and painful bone metastasis can also be used to disrupt nerve conduction. This work's purpose was to study the feasibility and safety of direct MRgFUS ablation of the lumbar MB nerve in acute and subacute swine models...
November 2016: International Journal of Hyperthermia
Qin Zhou, Fang Zhou, Long Wang, Kang Liu
OBJECTIVES: This study aims to observe the clinical efficacy and feasibility of improved X-rays-guided radiofrequency thermocoagulation denervation for treating low back pain secondary to lumbar facet joint syndrome (LFJS). PATIENTS AND METHODS: Eighty LFJS patients were randomly assigned into two groups: the denervation group (n=40), treated with percutaneous radiofrequency thermocoagulation denervation on the lumbar facet joint, and the control group (n=40), injected with betamethasone and lidocaine into the lumbar facet joint...
September 2016: Clinical Neurology and Neurosurgery
J Fleisch, A Dahan
Pain from the sacroiliac (SI) joint is, along with osteoarthritis of the facet joints, one of the main sources of mechanical low back pain. Here we discuss the negative results of two recent randomized controlled trials in the Netherlands on the use of radiofrequency (RF) denervation to treat low back pain arising from the SI joint. Possible causes of treatment failure are discussed. The authors also discuss the use of an intra-articular injection of the combination of a local anaesthetic and a glucocorticoid as an alternative to RF denervation...
2016: Nederlands Tijdschrift Voor Geneeskunde
Timothy J Amrhein, Anand B Joshi, Peter G Kranz
OBJECTIVE: The purpose of this study is to describe the procedure for CT fluoroscopy-guided lumbar medial branch blocks and facet radiofrequency ablation. CONCLUSION: CT fluoroscopic guidance allows more-precise needle tip positioning and is an alternative method for performing medial branch blocks and facet radiofrequency ablation.
September 2016: AJR. American Journal of Roentgenology
Jinyoung Oh, Daehyun Jo, Koohyun Kim, Jungwoo Shim, Misun Roh
UNLABELLED: Lumbar spinal stenosis is one of most common pathologic conditions affecting the lumbar spine. Pain and/or disability in the low back and lower extremities with or without neurogenic claudication may occur as a result of compression of dural sac contents or nerve roots in the narrowed space. Bulging and protrusion, facet joint hypertrophy, and disc herniation combined with osteophytes and arthritic changes of facet joints can be the cause of lumbar spinal stenosis. Medical/interventional treatment may be considered as an initial treatment for patients with mild symptoms of lumbar spinal stenosis...
May 2016: Pain Physician
Laxmaiah Manchikanti, Joshua A Hirsch, Frank Je Falco, Mark V Boswell
AIM: To investigate the diagnostic validity and therapeutic value of lumbar facet joint interventions in managing chronic low back pain. METHODS: The review process applied systematic evidence-based assessment methodology of controlled trials of diagnostic validity and randomized controlled trials of therapeutic efficacy. Inclusion criteria encompassed all facet joint interventions performed in a controlled fashion. The pain relief of greater than 50% was the outcome measure for diagnostic accuracy assessment of the controlled studies with ability to perform previously painful movements, whereas, for randomized controlled therapeutic efficacy studies, the primary outcome was significant pain relief and the secondary outcome was a positive change in functional status...
May 18, 2016: World Journal of Orthopedics
J Martel Villagrán, Á Bueno Horcajadas, E Agrela Rojas
We aim to describe imaging-guided (ultrasound and CT) interventional techniques in the musculoskeletal system that can be performed by general radiologists, whether in hospitals, primary care clinics, private offices, or other settings. The first requirement for doing these procedures is adequate knowledge of the anatomy of the musculoskeletal system. The second requirement is to inform the patient thoroughly about the technique, the risks involved, and the alternatives available in order to obtain written informed consent...
May 2016: Radiología
Alexander Bautista, Alisher Dadabayev, Ellen Rosenquist, Jianguo Cheng
We report 2 cases of successful treatment of neck and back pain with bipolar radiofrequency ablation (RFA) of the cervical and lumbar facet joints in patients with an automatic implantable cardioverter defibrillator (AICD).Two patients with complex cardiac histories and AICD devices were treated with bipolar RFA of the facet joints. One presented with axial neck pain and the other with axial back pain. The histories and physical examinations were consistent with facetogenic pain. Diagnostic medial branch block resulted in more than 70% pain relief lasting for several days, allowing patients to perform routine daily activities without significant pain...
March 2016: Pain Physician
Sara Christensen Holz, Nalini Sehgal
BACKGROUND: Facet joint pain is a common cause of low back pain. There are no physical exam findings that provide a reliable diagnosis. Diagnosis is made by medial branch block injections (MBB). Once the source of pain has been determined, radiofrequency neurotomy (RFN) can be performed. Previous studies have shown that RFN reduces level of pain and improves function. No study has tried to correlate MBB results with outcomes after RFN. OBJECTIVES: (1) Estimate percentage decrease in pain, decrease in analgesic use, and increase in activity tolerance after facet joint radiofrequency neurotomy (2) Determine correlation between percentage pain relief or duration of pain relief after MBB and RFN outcomes...
March 2016: Pain Physician
Jorge F Ramirez Leon, Jose G Rugeles Ortiz, Enrique Osorio Fonseca, Carolina Ramirez Martinez, Gabriel Oswaldo Alonso Cuellar
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...
March 2016: Pain Physician
Mattia Pacetti, Pietro Fiaschi, Sergio Gennaro
BACKGROUND: Low back pain is an extremely common and often chronic condition. In some cases, this is due to an irritative arthropathy of zygapophyseal joint involving the medial branch of the dorsal ramus of the spinal nerve. Percutaneous radiofrequency thermocoagulation appears to be the most effective treatment to date, among a range of different treatments. In this paper, the technique is described as performed at out institution. METHODS: In supine position and under fluoroscopic control, a radiofrequency electrode is inserted into different articular zygapophyseal complexes to thermocoagulate ramifications of the medial branch of the dorsal primary ramus of the spinal nerve...
May 2016: Acta Neurochirurgica
G D Dhamale, V L Mathe, S V Bhoraskar, S N Sahasrabudhe, S Ghorui
The synthesis of nanocrystalline Nd2O3 through an inductively coupled radiofrequency thermal plasma route is reported. Unlike in conventional synthesis processes, plasma-synthesized nanoparticles are directly obtained in a stable hexagonal crystal structure with a faceted morphology. The synthesized nanoparticles are highly uniform with an average size around 20 nm. The nanoparticles are characterized in terms of phase formation, crystallinity, morphology, size distribution, nature of chemical bonds and post-synthesis environmental effects using standard characterization techniques...
February 26, 2016: Nanotechnology
Tim J Lamer, Jolene Smith, Bryan C Hoelzer, William D Mauck, Wenchun Qu, Halena M Gazelka
OBJECTIVE: The purpose of this study was to determine whether the energy generated by an active radiofrequency (RF) cannula adjacent to lumbar spine hardware could result in heating of the hardware. DESIGN: Prospective study. SETTING: Tertiary care medical center. SUBJECTS: Six patients with lumbar facet joint pain at the level adjacent to lumbar spine fusion hardware were studied. METHODS: A total of 10 lumbar medial branch nerve radiofrequency lesion procedures were performed on six patients...
September 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Laxmaiah Manchikanti, Joshua A Hirsch, Alan D Kaye, Mark V Boswell
Diagnostic facet joint nerve blocks have been utilized in the diagnosis of cervical facet joint pain in patients without disk herniation or radicular pain due to a lack of reliable noninvasive diagnostic measures. Therapeutic interventions include intra-articular injections, facet joint nerve blocks and radiofrequency neurotomy. The diagnostic accuracy and effectiveness of facet joint interventions have been assessed in multiple diagnostic accuracy studies, randomized controlled trials (RCTs), and systematic reviews in managing chronic neck pain...
January 2016: Postgraduate Medicine
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