gms | German Medical Science

72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Radiofrequency denervation therapy for lumbar facet joint arthropathy – enhanced outcome compared with chemical neurolysis (ethyl alcohol 95% or glycerol 20%)

Radiofrequenzdenervierung für Facettengelenksarthropathie hat bessere Ergebnisse in der Schmerzreduktion und Lebensqualität im Vergleich zur chemischen Neurolyse (Ethylalkohol 95% oder Glycerol 20%)

Meeting Abstract

  • presenting/speaker Anas Afifi - Rhein Maas Klinikum, Klinik für Wirbelsäulenchirurgie, Neurochirurgie und spezielle Orthopädie, Würselen, Deutschland
  • Mathis Ringe - Rhein Maas Klinikum, Klinik für Wirbelsäulenchirurgie, Neurochirurgie und spezielle Orthopädie, Würselen, Deutschland
  • Rolf Sobottke - Rhein Maas Klinikum, Klinik für Wirbelsäulenchirurgie, Neurochirurgie und spezielle Orthopädie, Würselen, Deutschland
  • Stavros Oikonomidis - Universitätsklinikum Köln, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Köln, Deutschland
  • presenting/speaker Michel Teuben - Rhein Maas Klinikum, Klinik für Wirbelsäulenchirurgie, Neurochirurgie und spezielle Orthopädie, Würselen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV204

doi: 10.3205/21dgnc199, urn:nbn:de:0183-21dgnc1998

Published: June 4, 2021

© 2021 Afifi et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Chronic low back pain is a major source of disability and loss work productivity worldwide.Treatment modalities of back pain due to facet joint arthorpathy include chemical neurolysis (Ethyl Alcohol or Glycerol) and radiofrequency denervation of lumbar facet joints. Long-term outcome of these semi invasive techniques are currently unclear. We hypothesize that radiofrequency denervation is associated with superior pain abolishment and less complications than chemical neurolysis.

Methods: Prospective study between 01.12.2017 and 01.12.2019. Adult patients with recurrent chronic low back pain, resistant to non-invasive therapy were included. Spinal imaging was performed to exclude alternative diagnoses. Patients were grouped based on treatment Modality into radiofrequency denervation (Gr. RFD), chemical neurolysis with Ethyl-Alcohol 95% (Gr. EA-95) and Glycerol 20% (Gr. Gly-20). The Core Outcome Measures Index for the back (COMI), WHO pain ladder level and VAS (Visual Analog Scale)-scores were determined. Outcome was determined pre-interventional, after 6 weeks, 6 and 12 months.

Results: 95 patients with a mean age of 63.7 years were included. Prior to intervention, a mean COMI-score of 8.31 and a VAS-score of 8.01 were encountered. A total of 30 patients underwent RFD, 35 patients were treated with EA-95 and 35 patients were exposed to Glycerol 20% neurolysis. No statistically significant differences were found between the three groups. Upon intervention however, patients treated by RFD had significantly lower VAS-levels compared with Ethyl Alcohol after 6 weeks (VAS: 4.33 vs.6,12 (P<0.05)). Also, after 6 months both VAS and COMI-scores were significantly decreased in RFD-patients than those treated by Gly-20 (respectively VAS:4.42 vs.6.64, P

Conclusion: The Radiofrequency denervation in therapy recurrent chronic lower back pain is associated with better results in pain reduction and quality of life compared to chemical neurolysis. High complication rate after chemical neurolysis with EA-95 compared to alternatives. In our view, in the absence of contraindications radiofrequency denervation should be considered as the treatment of choice in patients with symptomatic facet arthropathy.