21 January 2018
Int J Med Sci 2010; 7(3):120-123. doi:10.7150/ijms.7.120
Endoscopic Facet Debridement for the treatment of facet arthritic pain - a novel new technique
1. Chief of Pain Medicine and Anesthesiology
Study design: Retrospective, observational, open label.
Objective: We investigated the efficacy of facet debridement for the treatment of facet joint pain.
Summary of background data: Facet joint disease, often due to degenerative arthritis, is common cause of chronic back pain. In patients that don't respond to conservative measures, nerve ablation may provide significant improvement. Due to the ability of peripheral nerves to regenerate, ablative techniques of the dorsal nerve roots often provide only temporary relief. In theory, ablation of the nerve end plates in the facet joint capsule should prevent reinnervation.
Methods: All patients treated with endoscopic facet debridement at our clinic from 2003-2007 with at least 3 years follow-up were included in the analysis. Primary outcome measure was percent change in facet-related pain as measured by Visual Analog Scale (VAS) score at final follow-up visit.
Results: A total of 174 people (77 women, 97 men; mean age 64, range 22-89) were included. Location of facet pain was cervical in 45, thoracic in 15, and lumbar in 114 patients. At final follow-up, 77%, 73%, and 68% of patients with cervical, thoracic, or lumbar disease, respectively, showed at least 50% improvement in pain. Mean operating time per joint was 17 minutes (range, 10-42). Mean blood loss was 40 ml (range, 10-100). Complications included suture failure in two patients, requiring reclosure of the incision. No infection or nerve damage beyond what was intended occurred.
Conclusions: Our results demonstrate a comparable efficacy of endoscopic facet debridement compared to radiofrequency ablation of the dorsal nerve branch, with durable results. Large scale, randomized trials are warranted to further evaluate the relative efficacy of this surgical treatment in patients with facet joint disease.
Keywords: vertebral arthritis, facet syndrome, back pain, minimally invasive, nerve ablation
This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
How to cite this article:
Haufe SMW, Mork AR. Endoscopic Facet Debridement for the treatment of facet arthritic pain - a novel new technique. Int J Med Sci 2010; 7(3):120-123. doi:10.7150/ijms.7.120. Available from http://www.medsci.org/v07p0120.htm