Comparison of the effectiveness of radiofrequency neurotomy and endoscopic neurotomy of lumbar medial branch for facetogenic chronic low back pain: a randomized controlled trial

June 27, 2019 by Dr. Clemens Leave a Comment

Authors: Song K et al

World Neurosurgery (Feb 2019)

OBJECTIVE To compare the effectiveness of radiofrequency neurotomy (RN) and endoscopic neurotomy(EN) of lumbar medial branch (MB) for facetogenic chronic low back pain (FCLBP).

METHODS Forty patients with FCLBP were included and randomly assigned to the control group and the experimental group. The control group (20 cases) underwent X-ray-assisted RN and the experimental group (20 cases) underwent EN of the lumbar MB. The patients’ visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated and compared preoperatively, and at 3 weeks, 6 months, 1 year and 2 years post-operatively.

RESULTS 1. The RN group demonstrated successful treatment results (P＜0.05）at 3 weeks, 6 months and 1year after surgery. At 2 years, patients reported no significant effectiveness (P＞0.05).results 2. The EN group demonstrated more prolonged successful treatment outcomes compared to the RN group. At 2 years, although the efficacy declined further. The VAS and ODI scoresVAS and ODI scores showed significant improvements compared with the preoperative data (P＜0.05）. 3. There is no difference of VAS and ODI scores between two groups at 3 weeks after surgery (P＞0.05). At 6 months and later, the EN group demonstrated better outcomes (P＜0.05).

CONCLUSIONS For FCLBP, EN and X-ray-assisted RN of lumbar MB are both effective treatments. However, endoscopic lumbar MB neurotomy has the better and longer effectiveness.

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