PERCUTANEOUS RADIOFREQUENCY LUMBAR FACET DENERVATION FOR CHRONIC LOW-BACK-PAIN - RESULTS IN 103 PATIENTS

The facet syndrome seems to be a common cause of low back pain. Percut aneous radiofrequency lumbar facet denervation, developed by Shealy, m ay be of therapeutic value in facet syndrome patients. This method con sists in thermocoagulation of the middle branch of the dorsal primary ramus of the spinal nerve. The authors report their experience with th is technique in a retrospective series of 103 patients with chronic lo w back pain ascribed to facet syndrome. Results were evaluated after 6 and 24 months using a questionnaire and the Stauffer and Coventry cla ssification. Among the 86 patients who completed the questionnaire, 38 .4% considered the treatment successful, whereas 61.6% considered that it had not been of benefit. According to the Stauffer and Coventry cl assification, there were 20.9% excellent results, 22.1% fair results, and 57% failures. Results were better in those patients with a negativ e history for surgical discectomy. Success rates reported in the liter ature vary widely, from 14% to 76%. Interpretation of these data is di fficult since studies used a broad range of treatment techniques, eval uation methods, and patient selection criteria. A prospective study us ing stringent inclusion criteria and appropriate evaluation criteria t aking quality of life into account is needed to determine the role of percutaneous facet denervation among other treatment options available to low back pain patients.