A pilot cohort study of lumbar facet joint denervation in patients with chronic low-back pain

Rune Tendal Paulsen*, Leah Y Carreon, Frederik Busch, Alexander Isenberg-Jørgensen

*Corresponding author for this work

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Abstract

INTRODUCTION: Radio-frequency (RF) denervation of the facet joints is a procedure aimed at the nociceptive median branch nerves of the lumbar dorsal rami. Pain signals from the facet joints are carried through these fibres; by ablating these fibres, central signalling can be prevented. This pilot study investigated the clinical effect and feasibility of the procedure at our institution, the Spine Centre of Southern Denmark. METHODS: Patients with at least 50% pain relief after initial medial branch diagnostic blocks were candidates for RF denervation. Patients were divided into two groups: 1) patients with at least 80% pain relief and 2) patients with between 50% and 79% pain relief after diagnostic blocks. Denervation was performed bilaterally on the three lowest facet joints in the lumbar spine. The primary outcome parameter was visual analogue scale (VAS). Follow-up questionnaires were answered after one week and after three, six and 12 months. RESULTS: For the whole sample, we found a mean reduction of 43 VAS points after one week. At three months, we found a mean reduction of 25 points. Six-month data showed a mean 19-point reduction. Twelve-month data showed a mean reduction of 17 points. Group 1 showed superior improvements at all follow-up points and after 12 months, we found a mean VAS reduction of 22 points for this group. CONCLUSIONS: This pilot cohort study found RF denervation of the facet joint to be a promising alternative for patients with chronic low-back pain. The effect persisted at the one-year follow-up; however, the effect diminished over time.

Original languageEnglish
Article numberA5533
JournalDanish Medical Journal
Volume66
Issue number3
Number of pages5
ISSN2245-1919
Publication statusPublished - 1. Mar 2019

Keywords

  • Chronic Pain
  • Denervation/methods
  • Denmark
  • Female
  • Humans
  • Low Back Pain/radiotherapy
  • Lumbar Vertebrae
  • Male
  • Nerve Block
  • Pilot Projects
  • Prospective Studies
  • Surveys and Questionnaires
  • Visual Analog Scale
  • Zygapophyseal Joint/innervation

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