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  • Conservative Management Versus Facet Denervation For The Treatment Of Spondylogenic Low Back Pain Due To Facet Arthropathy

    Final Number:

    Mohammed Mostafa Agamy MD, MBBch; Zaki Seddik; Hassan Ali El Bahrawy; khaled aref; Wael Mohammed Moussa

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: Low back pain is the most common musculoskeletal disorder of most societies and the most common cause of disability in persons younger than 45 years. The lumbo-sacral facet joint is reported to be the source of pain in 15-40% of patients with chronic low back pain

    Methods: sixty randomly selected patients complaining of chronic low back pain were equally divided into 2 groups:one subjected to conservative treatment including medications and physiotherapy. And the second underwent percutaneous radio-frequency facet denervation

    Results: Radiofrequency denervation has proven success in relieving pain as evidenced by excellent and good pain relief immediately after treatment in 86.7% of cases of the group who underwent the procedure as compared to 20% of cases of the group who underwent conservative managment, after three months pain relief has declined in the long term follow up as evidenced by excellent and good pain relief in 73% of cases of first group as compared to 10% of cases of the second group . This study also showed that 80 % of patients who underwent radiofrequency denervation returned to normal activity compared to 26% of patients who had conservative treatment.

    Conclusions: Radiofrequency facet denervation is an effective, valuable method in relieving low back pain of patients with lumbar facet syndrome for short and long term period, It is minimally invasive procedure where the morbidity is low in expert hands when the procedure is properly performed, well tolerated with minimal complications and can be performed as an outpatient procedure

    Patient Care: it will improve the management of patient with low back pain which is a common complaint in the neurosurgery outpatient clinic, it also provides a way to apply an easy outpatient rapid procedure for alleviating that pain for a longer time allowing patient to return to their normal daily activity and consume less medications to relieve their pains

    Learning Objectives: By the conclusion of this session, participants should be able to: 1)descripe the importance of radiofrequency denervation as a valuable method for treating chronic low back pain due to facet arthropathy 2)discuss in groups how to select patients properly for the procedure and counsel the patient for the procedure 3)identify the exact target point where we can produce the radiofrequency lesion


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