Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지

Percutaneous Radiofrequency Facet Rhizotomy for Cervical Dorsal Ramus Syndrome

  • Cho, Tack-Geun (Department of Neurosurgery, College of Medicine, Chung-Ang University) ;
  • Hwang, Sung-Nam (Department of Neurosurgery, College of Medicine, Chung-Ang University) ;
  • Park, Seung-Won (Department of Neurosurgery, College of Medicine, Chung-Ang University) ;
  • Nam, Taek-Kyun (Department of Neurosurgery, College of Medicine, Chung-Ang University) ;
  • Hong, Hyun-Jong (Department of Neurosurgery, College of Medicine, Chung-Ang University) ;
  • Kim, Young-Baeg (Department of Neurosurgery, College of Medicine, Chung-Ang University)
  • Published : 2006.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : Radiofrequency facet rhizotomy[RFFR] has been widely performed for treatment of chronic neck pain caused by cervical dorsal ramus syndrome[CDRS]. To evaluate the therapeutic effectiveness of RFFR in the patients with CDRS, we analyzed patients with various cervical pathologic conditions. Methods : The therapeutic results in forty-four patients who underwent RFFR for CDRS from January, 2000 to December, 2002 were analyzed according to the underlying pathologic conditions causing CDRS. The pathologic conditions were sprain [33 cases], herniated nucleus pulposus [6], foraminal stenosis [4], and compression fracture [1]. The therapeutic results were evaluated one month after the operation and graded as excellent, good, fair of poor. Treatments were considered successful if the therapeutic results were graded as either excellent of good. Results : The overall success rate in all patients was 72.7%. The success fate for treatment of cases with cervical sprain was 87.9%, but treatment of cases with herniated nucleus pulposus, foraminal stenosis, and fracture showed unsatisfactory results [mean success rate was 27.3%]. Some patients complained of transient hypesthesia [4 cases] of transient dull pain at the electrode insertion sites [2 cases]. Conclusion : RFFR is an effective and safe treatment for CDRS caused by cervical sprain, regardless of the patient's age, the duration of the symptoms, and the presence of radiating pain.

Keywords

References

  1. Fairbank J, Pynsent PB : The Oswestry disability index. Spine 25 : 2940- 2952, 2000 https://doi.org/10.1097/00007632-200011150-00017
  2. Jackson RP : The facet syndrome. myth or reality? Clin Orthop Relat Res 279 : 110-121, 1992
  3. Joy H, Ha SK, Kim SH, Lim DJ, Park JY, Suh JK : Prognostic factors of percutaneous radiofrequency neurotomy on the posterior primary ramus. J Korean Neurosurg Soc 33 : 51-55, 2003
  4. Lord SM, Barnsley L, Bogduk N : Percutaneous radiofrequency neurotomy in the treatment of cervical zygapophysial joint Pain : a caution. Neurosurgery 36 : 732-739, 1995 https://doi.org/10.1227/00006123-199504000-00014
  5. McDonald GJ, Lord SM, Bogduk N : Long-term follow-up of patients treated with cervical radiofrequency neurotomy for chronic neck pain. Neurosurgery 45 : 61-68, 1999 https://doi.org/10.1097/00006123-199907000-00015
  6. Nam TG, Park SW : Lumbar dorsal ramus syndrome-management with radiofrequency facet rhizotomy. J Korean Neurosurg Soc 34 : 319- 324, 2003
  7. Sapir DA, Gorup JM : Radiofrequency medial branch neurotomy in litigant and nonlitigant patients with cervical whiplash : a prospective study. Spine 26 : 268-273, 2001 https://doi.org/10.1097/00007632-200106150-00016
  8. Scott J, Huskisson EC : Graphic representation of pain. Pain 2 : 175- 184, 1976 https://doi.org/10.1016/0304-3959(76)90113-5
  9. Seymour RA, Simpson JM, Charlton JE, Phillips ME : An evaluation of length and end-phrase of visual analogue scales in dental pain. Pain 21 : 177-185, 1985 https://doi.org/10.1016/0304-3959(85)90287-8
  10. 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
  11. Shin WR, Kim HI, Shin DG, Shin DA : Radiofrequency neurotomy of cervical medial branches for chronic cervicobrachialgia. J Korean Med Sci 21 : 119-125, 2006 https://doi.org/10.3346/jkms.2006.21.1.119
  12. Tzaan WC, Tasker RR : Percutaneous radiofrequency facet rhizotomyexperience with 118 procedures and reappraised of its value. Can J Neurol Sci 27 : 125-130, 2000
  13. Van Zundert J, Harney D, Joosten EA, Durieux ME, Patijn J, Prins MH, et al : The role of the dorsal root ganglion in cervical radicular pain : diagnosis, pathophysiology, and rationale for treatment. Reg Anesth Pain Med 2 : 152-167, 2006
  14. Ware JE Jr, Sherbourne CD : The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30 : 473-483, 1992 https://doi.org/10.1097/00005650-199206000-00002
  15. Wilkie DJ, Savedra MC, Holzemer WL, Tesler MD, Paul SM : Use of the McGill pain questionnaire to measure pain : a meta-analysis. Nurs Res 39 : 36-41, 1990
  16. Zervas NT, Kuwayama A : Pathological characteristics of experimental thermal lesions : Comparison of induction heating and rediofrequency electrocoagulation. J Neurosurg 37 : 418-422, 1972 https://doi.org/10.3171/jns.1972.37.4.0418