Comparison of percutaneous radiofrequency medial branch neurotomy and endoscopic medial branch rhizotomy for lumbar zygapophysial ( facet ) joint pain
SONG Ke-ran
CAO Zheng
ZHAO Hong-liang
QIN Jiang
SHANG Wei-lin
HOU Shu-xun
LI Zhen-zhou
Abstract：Objective To gather outcome data of percutaneous radiofrequency neurotomy and endoscopic rhizotomy of the lumbar medial branch for facetogenic chronic low back pain, and to compare treatment efficacy of the two approaches. Methods Forty facetogenic chronic low back pain patients were included and randomly assigned to receive percutaneous radiofrequency neurotomy ( RN group, 20 cases ) or endoscopic neurotomy of the lumbar medial branch ( EN group, 20 cases ). Endoscopic neurotomy was performed for the second group. Outcomes were obtained by VAS, ODI and SF-36 preoperatively and at 3 weeks, 6 months, 1 year and 2 years postoperatively. The results of two groups were compared. Results RN group demonstrated excellent results at 3 weeks after operation [ VAS Score decreased from ( 7.15 ± 0.81 ) pre-operatively to ( 2.60 ± 0.75 ) post-operatively; ODI Score decreased from ( 76.75 ± 7.07 ) to ( 28.00 ± 3.84 ); while SF-36 Score increased from ( 79.01 ± 13.81 ) to ( 92.67 ± 11.13 ). The treatment achieved an improve rate of ( 63.04 ± 12.49 ) % and an excellence rate of 100% ]. At 6 months after operation, the clinical data VAS Score, ODI Score and SF-36 Score were ( 3.85 ± 0.88 ), ( 32.50 ± 4.44 ), ( 87.32 ± 17.20 ), indicating less improvement with an improvement rate of ( 45.68 ± 13.18 ) % and an excellence rate of 60%. At 2 years after the operation, patients' conditions became the same as 2 years ago ( P > 0.05 ). EN group demonstrated prolonged excellent clinical outcomes compared with the RN group. At 6 months after operation, VAS Score, ODI Score and SF-36 Score were ( 3.15 ± 0.57 ), ( 27.50 ± 2.96 ), ( 87.89 ± 14.49 ), indicating an improvement rate of ( 55.45 ± 9.01 ) % and an excellence rate of 90%. At 1 year after operation, the efficacy declined. VAS Score, ODI Score and SF-36 QOF Score were ( 3.40 ± 0.68 ), ( 35.70 ± 5.81 ), ( 81.53 ± 12.02 ), indicating an improvement rate of ( 51.49 ± 12.83 ) % and an excellence rate of 80%. At 2 years after operation, the efficacy further declined. VAS Score, ODI Score and SF-36 QOF Score decreased to ( 3.93 ± 0.75 ), ( 44.35 ± 3.99 ), ( 77.86 ± 10.75 ), indicating an improvement rate of ( 44.17 ± 11.33 ) % and an excellence rate of 45%. The data showed significant improvement compared with pre-operative data ( P < 0.05 ). There were no significant differences of VAS Score, ODI Score and SF-36 Score between the 2 groups at 3 weeks after operation ( P > 0.05 ). At 6 months and later after operation, RN group demonstrated better outcomes ( P < 0.05 ). Conclusions For facetogenic chronic low back pain, endoscopic neurotomy and X-ray assisted percutaneous radiofrequency neurotomy of the lumbar medial branch are both effective. Endoscopic lumbar medial branch neurotomy has the advantages of higher surgical precision and better long-term efficacy.
Keywords：Low back painEndoscopesSpinal nervesPulsed radiofrequency treatmentRhizotomy
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 429-436 )