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      Bipolar Intra-articular Radiofrequency Thermocoagulation of the Thoracic Facet Joints: A Case Series of a New Technique

      research-article
      Author(s):
      Publication date (Electronic):
      Journal: The Korean Journal of Pain
      Publisher: The Korean Pain Society
      Keywords: facet, radiofrequency, thermocoagulation, thoracic

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          Abstract

          Background

          This study tests the hypothesis that of bipolar radiofrequency thermocoagulation of the thoracic facet joint capsule may provide a safe and effect method of pain control from thoracic facet origin.

          Methods

          Among patients suffering from localized mid back pain, nine patients with thoracic facet disease confirmed by magnetic resonance image and diagnostic thoracic facet block were enrolled. Bipolar radiofrequency ablation in the inferior aspect of the thoracic facet joint was done. Visual Analog Scale (VAS) was measured pre-intervention and 1 month post-intervention. Any complications and changes in amount of pain medication were recorded.

          Results

          Significant 47.6% reduction in VAS was noted at 1 month. There were no serious complications.

          Conclusions

          Intra-articular bipolarradiofrequency thermocoagulation of the thoracic facet joint may be a technically easier and valid method of treating mid back pain of thoracic facet origin.

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          Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions

          Laxmaiah Manchikanti, Mark Boswell, Vijay Singh … (2004)
          Background Facet joints are a clinically important source of chronic cervical, thoracic, and lumbar spine pain. The purpose of this study was to systematically evaluate the prevalence of facet joint pain by spinal region in patients with chronic spine pain referred to an interventional pain management practice. Methods Five hundred consecutive patients with chronic, non-specific spine pain were evaluated. The prevalence of facet joint pain was determined using controlled comparative local anesthetic blocks (1% lidocaine or 1% lidocaine followed by 0.25% bupivacaine), in accordance with the criteria established by the International Association for the Study of Pain (IASP). The study was performed in the United States in a non-university based ambulatory interventional pain management setting. Results The prevalence of facet joint pain in patients with chronic cervical spine pain was 55% 5(95% CI, 49% – 61%), with thoracic spine pain was 42% (95% CI, 30% – 53%), and in with lumbar spine pain was 31% (95% CI, 27% – 36%). The false-positive rate with single blocks with lidocaine was 63% (95% CI, 54% – 72%) in the cervical spine, 55% (95% CI, 39% – 78%) in the thoracic spine, and 27% (95% CI, 22% – 32%) in the lumbar spine. Conclusion This study demonstrated that in an interventional pain management setting, facet joints are clinically important spinal pain generators in a significant proportion of patients with chronic spinal pain. Because these patients typically have failed conservative management, including physical therapy, chiropractic treatment and analgesics, they may benefit from specific interventions designed to manage facet joint pain.
          Article 0 comments Cited 65 times – based on 0 reviews     Review now
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            A population-based study of spinal pain among 35-45-year-old individuals. Prevalence, sick leave, and health care use.

            S. Linton, K Halldén, A Hellsing (1998)
            A questionnaire was mailed to 3000 randomly selected 35-45-year-old individuals in three communities in central Sweden. To study the 1-year prevalence of spinal pain and its ramifications in the form of pain, function, sick leave, and health care use. Previous researchers have used a variety of definitions and populations, but primarily have investigated the occurrence of pain. Comprehensive data are needed concerning health care use, the degree of the pain problem, functional disturbances, and sick leave. Participants in the study completed a questionnaire regarding spinal pain during the past year including the degree of their experienced pain, functional impairment, lost work days, and health care use. A total of 2305 people (78.5%) responded to the questionnaire. Nonrespondents had similar characteristics but a slightly lower 1-year prevalence rate than did respondents. For respondents, the prevalence of spinal pain during the past year was 66.3%, with women having a slightly higher prevalence than men. Approximately 25% of the respondents indicated that they had a substantial problem based on ratings of pain, functional impairment, and sick leave. Work absenteeism reported to the Public Social Insurance Office involved 19% of those with pain, but an additional 15% indicated unreported absenteeism. On average, those with pain visited health care providers three times during the past year, but a small number of those who experienced pain consumed large amounts of health care and illness benefits. An important gender difference was shown, such that when pain was at its worst, men took sick leave, whereas women sought health care. Taken together, these data indicate that spinal pain is common among 35-45-year-old men and-women, and that it is related to marked problems for approximately one fourth of those who experience pain. Gender differences exist in the pattern of sick leave and health care use, and a small proportion of those with pain consume very large amounts of the resources. Consequently, there is a need for early, effective, preventive treatments.
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              Radiofrequency sacroiliac joint denervation for sacroiliac syndrome.

              F M Ferrante, L King, E Roche … (2015)
              Radiofrequency (RF) denervation of the sacroiliac (SI) joint has been advocated for the treatment of sacroiliac syndrome, yet no clinical studies or case series support its use. We report the results of a consecutive series of 50 SI joint RF denervations performed in 33 patients with sacroiliac syndrome. All patients underwent diagnostic SI joint injections with local anesthetic before denervation. Changes in visual analog pain scores (VAS), pain diagrams, physical examination (palpation tenderness over the joint, myofascial trigger points overlying the joint, SI joint pain provocation tests, and range of motion of the lumbar spine), and opioid use were assessed pre- and postdenervation. The criteria for successful RF denervation were at least a 50% decrease in VAS for a period of at least 6 months; 36.4% of patients (12 of 33) met these criteria. Failure of denervation correlated with the presence of disability determination and pain on lateral flexion to the affected side. The average duration of pain relief was 12.0 +/- 1.2 months in responders versus 0.9 +/- 0.2 months in nonresponders (P < or = 0.0001). A positive response was associated with an atraumatic inciting event. Successful denervation was associated with a change in the pain diagram and a reduction in the pattern of referred pain, a normalization of SI joint pain provocation tests, and a reduction in the use of opioids. This study suggests that RF denervation of the SI joint can significantly reduce pain in selected patients with sacroiliac syndrome for a protracted time period. Moreover, certain abnormal physical findings (i.e., SI joint pain provocation tests) revert to normal for the duration of the analgesia.
              Article 0 comments Cited 24 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Korean J Pain
                Journal ID (iso-abbrev): Korean J Pain
                Journal ID (publisher-id): KJP
                Title: The Korean Journal of Pain
                Publisher: The Korean Pain Society
                ISSN (Print): 2005-9159
                ISSN (Electronic): 2093-0569
                Publication date (Print): January 2014
                Publication date (Electronic): 31 December 2013
                Volume: 27
                Issue: 1
                Pages: 43-48
                Affiliations
                Department of Anesthesiology, Division of Pain Medicine, Henry Ford Medical Center, Detroit, USA.
                Author notes
                Correspondence to: David Kim. Department of Anesthesiology, Division of Pain Medicine, I-3 Pain Clinic, Henry Ford Medical Center, 2799 West Grand Blvd, Detroit Michigan 48202, USA. Tel: +1-313-622-7107, Fax: +1-313-916-8023, Dkim1@ 123456hfhs.org
                Article
                DOI: 10.3344/kjp.2014.27.1.43
                PMC ID: 3903800
                PubMed ID: 24478900
                SO-VID: 4d3f6422-022f-4c98-aeea-a5088994a1db
                Copyright © Copyright © The Korean Pain Society, 2014
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 07 October 2013
                Date revision received : 02 December 2013
                Date accepted : 05 December 2013
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: radiofrequency,thoracic,thermocoagulation,facet
                Data availability:
                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: radiofrequency, thoracic, thermocoagulation, facet

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