Radiofrequency facet joint denervation efficiency based on the severity of spondylarthrosis and in osteoporotic vertebral compression fractures. A retrospective study

Márton Balázsfi, Dávid Kis, Tamás Tóth, Tamás Zsoldos, P. Barzó

Research output: Contribution to journalArticle

Abstract

Objectives: Radiofrequency denervation of the facet joints is performed via a well-established method. Its primary, direct indication is a positive response to a nerve block injection (MBB). Our study aimed to find other, effective but indirect indication signs through the retrospective analysis of our patients treated earlier. Patients and methods: In our institute between 1 January, 2008 and 31 December, 2017 facet joint denervation has been performed in more than 2000 cases, and we included 529 patients in our retrospective study. We had separate groups for vertebral compression fractures and for spondylarthrosis of different severity (Grade 1; 2–3; 4), thus we assessed the postoperative condition of these patients using Visual Analoge Scale (VAS). The efficacy of the intervention was examined in every groups separately according to symptoms and previous spine surgeries. Results: In view of our results, chronic lumbago and dorsalgia that are attributable to osteoporotic vertebral compression fracture are obvious indications if they do not respond to conservative therapy, as 76.8% of such patients remained asymptomatic for minimum 6 months (p = 0,000). Another indication is Grade 2 or 3 chronic spondylarthrosis without radicular involvement, since these groups reported a 51.4% success rate (asymptomatic for minimum 6 months) (p = 0,015). Long term pain relief is obviously impaired by the presence of radicular compression, as we were not able to decrease the pain of 97% of such patients. Our findings also suggest that the vast majority of those who have previously undergone spine surgery cannot benefit from the intervention. Conclusion: Based on this study, facet joint denervation can serve as an effective therapy supplement in a properly selected group of patients who do not respond to oral NSAIDs, exercise and physiotherapy. By this procedure we found we can reach long term benefit in the groups of osteoporotic vertebral fracture patients and patients with moderate spondylarthrosis. According to our results and the literature datas the properly patient selection for the indication of the RF ablation can be as effective as the controversial diagnostic nerve block injections.

Original languageEnglish
Article number105497
JournalClinical Neurology and Neurosurgery
Volume186
DOIs
Publication statusPublished - Nov 1 2019

Fingerprint

Zygapophyseal Joint
Compression Fractures
Denervation
Retrospective Studies
Nerve Block
Spine
Pain
Injections
Osteoporotic Fractures
Non-Steroidal Anti-Inflammatory Agents
Low Back Pain
Patient Selection
Exercise

Keywords

  • Facet joint
  • Radiofrequency denervation
  • Spondylarthrosis
  • Vertebral compression fracture

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Radiofrequency facet joint denervation efficiency based on the severity of spondylarthrosis and in osteoporotic vertebral compression fractures. A retrospective study. / Balázsfi, Márton; Kis, Dávid; Tóth, Tamás; Zsoldos, Tamás; Barzó, P.

In: Clinical Neurology and Neurosurgery, Vol. 186, 105497, 01.11.2019.

Research output: Contribution to journalArticle

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AU - Barzó, P.

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