Prognostic Factors of Percutaneous Radiofrequency Neurotomy on the Posterior Primary Ramus.

Joy, Hoon; Ha, Sung Kon; Kim, Se Hoon; Lim, Dong Jun; Park, Jung Yul; Suh, Jung Keun

Original Article

Journal of Korean Neurosurgical Society 2003;33(1): 51-55.

Hoon Joy, Sung Kon Ha, Se Hoon Kim, Dong Jun Lim, Jung Yul Park, Jung Keun Suh

Department of Neurosurgery, Korea University Medical School, Ansan, Korea. jypark@kumc.or.kr

ABSTRACT

OBJECTIVE
We report our experience of percutaneous radiofrequency neurotomy(PRN) on the posterior primary ramus with at least two years follow up. METHODS: Two hundred and twenty-eight patients were underwent PRN on the posterior primary ramus for refractory low back pain during last three years. One hundred and twenty-eight patients were met all inclusion criteria indicating facetal originated pain(group II), and 100 patients were not(group I). Radiofrequency procedures were done in usual manner. Pain reliefs were estimated at 1 week, 1 month, 6 months and 2 years using visual analog scale. RESULTS: Positive responders were 56% at 1 week, 46% at 1 month, 18% at 6 months, and 13% at 2 years after PRN in group I, and 78.9% at 1 week, 75.4% at 1 month, 62.5% at 6 months, and 54.7% at 2 years in group II. Prominent local tenderness, percussion tenderness, pain on getting up, extension and transitional movement, radiating pain on buttock and/or posterior thigh, and good immediate response were found to be significantly related to outcome. And age, sex, symptom duration, bilateral symptoms, favorable imaging study results, previous lumbar surgery, and degrees of pain relief from diagnostic block were not.
CONCLUSION
Percutaneous radiofrequency neurotomy on the posterior primary ramus has long-term beneficial effect, without any morbidity in our series. And the long-term good results will be anticipated after proper selection among patients with facet joints related low back pain.

Key Words: Low back pain; Radiofrequency neurotomy; Posterior primary ramus; Facet joint