Long-Term Results of Facet Denervation
Low back pain and referred leg pain seem to be the result of mechanical alterations in the facet joints (facet syndrome), conservative management of which is unlikely to be of benefit. We took up the suggestion of treating these pains by cutting off the articular nerve supply of the spinal facets in patients whose clinical symptoms and myelography or CT scan did not show any evidence of nerve root involvement. We used the percutaneous technique introduced by SHEALY in 1974. Under fluoroscopic guidance, six cannulae were introduced adjacent to the three lowest facet joints on each side. A radiofrequency thermistor electrode was passed through the needles and the articular nerves were coagulated after testing the electrical stimulation and confirming the position of the electrode by X-ray. This procedure is simple, quick, and of nearly no risk. We only observed complications twice; once a temporary weakness of the quadriceps femoris muscle and once a skin burn caused by defective insulation of the electrode.
KeywordsFacet Joint Percutaneous Technique Mechanical Alteration Nerve Root Involvement Facet Syndrome
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