Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Radiofrequency Facet Denervation for Low Back Pain after Microscopic Discectomy

  • Kim, Seok-Won (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Lee, Seung-Myung (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Shin, Ho (Department of Neurosurgery, College of Medicine, Chosun University)
  • Published : 2005.12.28
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Abstract

Objective : There were few reports about statistically significant factor which contribute to low back pain[LBP] after microscopic discectomy. We analyzed the result of percutaneous radiofrequency neurotomy[PRN] for low back pain after microscopic discectomy in lumbar disc herniation. Methods : Forty four patients with LBP after microscopic discectomy who were treated by one level microscopic discectomy from January 2003 to March 2004 were included in this study. They were divided into two groups by the presence of preoperative LBP into preoperative back pain group [group I] and postoperative back pain group [group II]. Radiofrequency procedures were performed in the usual manner, targetting the medial branch of L4, L5 and Sl. Pain relief was estimated at 1 week, 1 month and 6 months following the procedure, using the visual analogue scale. Above 50% pain relief was defined as the positive response. Results : Positive responders were 16 patients [73%] at 1 week, 12 patients [55%] at 1 month, and 7 patients [32%] at 6 months after PRN in group I. In Group II, 18 patients, 15 patients and 13 patients responded positively after 1 week, 1 month and 6 months after PRN, respectively. Conclusion : PRN is an effective treatment for newly developed low back pain after microscopic discectomy. There was no morbidity in our series, but long-term follow up is necessary.

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References

  1. Cho J, Park YG, Chung SS : Percutaneous radiofrequency lumbar facet rhizotomy in mechanical low back pain syndrome. Stereotact Funct Neurosurg 68 : 212-217, 1997 https://doi.org/10.1159/000099926
  2. Dabbs VM, Dabbs LG : Correlation between disc height narrowing and low-back pain. Spine 15 : 1366-1369, 1990 https://doi.org/10.1097/00007632-199012000-00026
  3. Finneson BE : Low back pain, ed 2. philadelphia : JB Lippincott, 1980, pp320-326
  4. Hurme M, Alanranta H : Factors predicting the result of surgery for lumbar intervertebral disc herniation. Spine 12 : 933-938, 1987 https://doi.org/10.1097/00007632-198711000-00016
  5. Joy H, Ha SK, Kim SH, Lim DJ, Park JY : Prognostic factors of percutaneous radiofrequency neurotomy on posterior primary ramus. J Korean Neurosurg Soc 33 : 51-55, 2003
  6. Shealy CN : Percutaneous radiofrequency denervation of spinal facets. Treatment for chronic back pain and sciatica. J Neurosurg 43 : 448- 451, 1975 https://doi.org/10.3171/jns.1975.43.4.0448
  7. Tzaan WC, Tasker RR : Percutaneous radiofrequency facet rhizotomyexperience with 118 procedures and reappraisal of its value. Can J Neurol Sci 27 : 125-130, 2000
  8. Van Kleef M, Barednse GAM, Kessels A, Voets HM, Weber WEJ, de Lange S : Randomized trial of radiofrequency lumbar facet denervation for chronic low back pain. Spine 24 : 1937-1942, 1999 https://doi.org/10.1097/00007632-199909150-00013
  9. Weir BK : Prospective study of 100 lumbosacral discectomies. J Neurosurg 50 : 283-289, 1979 https://doi.org/10.3171/jns.1979.50.3.0283
  10. Yorimitsu E, Chiba K, Yoyama Y, Hirabayashi K : Long-term outcomes of standard discectomy for lumbar disc herniation; a follow-up study of more than 10 years. Spine 26 : 652-657, 2001 https://doi.org/10.1097/00007632-200103150-00019