| The Role of Percutaneous Lumbar Facet Rhizotomy in
Senior Citizens' Intractable Back Pain |
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Joo-Yong Lee , Joon Cho , Sung-Ho Lee , Young-Cho Koh , M.D |
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Deparment of Neurosurgery, Konkuk University Hospital, Seoul, Korea |
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| Abstract |
Objective
Medically intractable low back pain has been regarded as the one of the most complicated health
problem in old ages. Lumbar zygapohphysial nerves are currently believed to do the major role in recurrent chronic
low back pain production. The purpose of the present study was to review the clinical result of percutaneous lumbar
facet rhizotomy in geriatric patients with low back pain and to report its management role in senior citizens.
Patients and Method: Our study comprises 48 patients (29 females, 19 males) older than 65 years old who
underwent the RF rhizotomy procedure for chronic low back pain from January 2005 to December 2006. Patients
selection criteria for RF treatment were: at least 6 months history of pain prior to the procedure, failure of any
kind of conservative treatment and high risk group of general anesthesia. To evaluate the pain control effect, visual
analogue scale (VAS) and oswestry disability scale were scored by the patients before and after surgery.
Results
Mean follow-up period was 15±3 months. The mean visual analogue scores improved form 7.7 before
the procedure to 3.3 after immediate procedure. Mean VAS score was improved significantly from 7.7 to 3.5 at
4 weeks after surgery. Mean VAS score was 4.0 at 6 months after operation and 4.2 at 12 months after operation.
Twenty-two patients (45%) obtained at least 50% relief of pain at 12 months, and 34 patients (77%) obtained at
least 30% relief of pain at 12 months. Mean Oswestry disability scores were 56 at preoperation, and 29 at 12
months. No complication was found in this study except for mild tenderness on the treated area which spontaneously
resolve up to 3 weeks after the procedure.
Conclusion
We concluded that percutaneous radiofrequency facet rhizotomy may be a simple, safe and effective
treatment modality for chronic mechanical low back pain syndrome, especially in old aged, high risk to general anes thesia
patients. |
| Key Words:
LumbarㆍRhizotomyㆍBack painㆍGeriatricsㆍFacet |
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