• The Korean Journal of Pain
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• v.23 no.2
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• pp.137-141
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• 2010

Background: Facet joint have been implicated as a source of chronic low back pain. Radiofrequency denervation has demonstrated the most solid evidence. To increase safety and efficacy of treatment, computed tomography (CT) guidance injection has been used in several disease. The purpose of this study was to evaluate the efficacy of CT-guided radiofrequency rhizotomy in the treatment of facet joint pain. Methods: A total of 40 patients were randomized to undergo radiofrequency facet joint denervation under CT guidance or C-arm guidance. All patients were examined visual analogue scale (VAS) score before treatment, 1 month, and 3 months after treatment. Results: The VAS in both groups showed significant improvement over the 1-month interval. No significant difference in the VAS score among the group was observed. Conclusions: In this study there was no significant difference between CT guidance lumbar rhizotomy and C-arm guidance lumbar rhizotomy. Therefore CT-guided radiofrequency denervation of the lumbar facet joint was a minimally invasive technique that appears effective.

• Journal of Korean Neurosurgical Society
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• v.40 no.6
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• pp.419-422
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• 2006

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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.2
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• pp.93-97
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• 2009

Anatomy: Facet joint syndrome most often affects the lower back and neck and refers to pain that occurs in the facet joints, which are the connections between the vertebrae in the spine that enable the spine to bend and twist. Many physicians have believed that the usual lesion of facet syndrome was an anatomical impairments of facet joint itself.. Facet joint injection using local anesthetics is a reliable method for the diagnosis and treatment for facet syndrome. Etiology: One of many possible causes is imbalances that can occur in stress levels, hormone levels, and nutritional levels. These imbalances can adversely affect posture, which can lead to neck and back pain. The common disorder called facet syndrome exhibits lower back pain, with or without, radiating pain to buttock and thigh due to facet joint arthropathy. Pain in the facet joint is supposedly the secondary effect of narrowing of joint space by sustained muscle contracture around joints. Syndrome: Facet joint syndrome tends to produce pain or tenderness in the lower back that increases with twisting or arching the body, as well as pain that moves to the buttocks or the back of the thighs. Other symptoms include stiffness or difficulty standing up straight or getting out of a chair. Pain can be felt in other areas such as the shoulders or mid-back area. Treatment: Non-drug treatments include hot packs, ultrasound, electrical stimulation, and therapeutic exercises. Stimulating blood flow using massage or a hot tub may also help. Alternative treatments include yoga and relaxation therapy. If your pain persists after trying these treatments, a surgical procedure called radiofrequency rhizotomy, which destroys the sensory nerves of the joint, may bring relief. Facet joint injection has been helpful in diagnosis and therapy for this facet syndrome. Radiofrequency thermocoagulation of medial branches is known to be an effective method of relieving pain caused by facet joint problems. We conclude that spasmolytic treatment of muscles connecting the two vertebral articular space would be better for treatment and diagnosis of facet syndrome rather than facet block with local anesthetic and steroid only.